Chronic staff shortages are the bane of many radiology administrators’ professional lives. Faced with a shrinking labor pool and a decline in radiologic technologist programs, many administrators -- like Debra Lopez -- are at their wit’s end to fill vacant jobs.
As director of diagnostic imaging at Santa Clara Valley Medical Center in San Jose, CA, Lopez said she relies on contract workers from several agencies to fill 80% of her open staff positions. Another administrator, Terry Dowd of Valley Lutheran Hospital in Phoenix, said that 25% of the RT positions in her city go unfilled.
Fortunately, Dowd and Lopez attended Clint Maun's presentation at the American Healthcare Radiology Administrators (AHRA) Changing Workforce conference in Phoenix earlier this month. Maun, senior partner at Omaha, NE-based healthcare consultants Maun-Lemke, offered a blueprint for recruiting, selecting, and retaining quality employees.
"Here’s a paradigm to consider: There’s plenty of help. It just doesn’t currently work for you," Maun said. "That sets in motion a whole new set of angles, including competitive marketing, targeted advertising, and cannibalizing the neighbors. But to make these tactics successful, you have to put your own house in order," he said.
The 12-week team
Maun said radiology administrators should approach staffing issues as a breakthrough strategy, and make them a top priority for their departments. To do this, he recommended that managers avoid relying on their human resources (HR) departments to deliver talent. Instead, administrators should partner with HR to create a 12-week plan to retain and recruit staff.
"Statistically, we’ve found that 90-day plans are the most successful. Shorter plans do not get enough traction, and longer plans breed complacency," Maun said.
To ensure success, managers need to form a team of four to seven people, including top radiology technologists from the department, HR representatives, and facility administration.
"Being a member of this team must be perceived as an honor. This is not the place to put individuals in need of ‘fixing up’ or oversight," Maun noted.
The team must create a written plan for improving retention and staffing of the radiology department that specifically answers the following questions:
- How many staff will the department hire?
- How much will agency staffing be reduced?
- How much will turnover will be reduced?
The plan should designate who will accomplish what and when. Each task should be carved into week-long segments, and task results presented to the team at weekly meetings. Accountability is crucial to success, he said.
The team should also hone in on what Maun called micro-goals -- that is, quantifiable improvements achieved on a per-shift basis. For instance, if a department were using agency staffing to cover 20 shifts per month, a micro-goal might be to reduce this number to four shifts weekly. Other micro-goals could aim at reducing turnover, or the number of absences each week.
When a micro-goal is achieved, the "win" must be shared with the staff, he said. This could be a luncheon for the department or a gift certificate for each staff member. For administrators who might blanch at the cost of rewards, Maun notes that it currently costs $14,000 to hire a single technologist.
"You can either spend functional money building a team of committed professionals, or you can spend dysfunctional money perpetuating a hire-train-turnover cycle," he said.
Talent retention
The first step in addressing staff shortages is for administrators to gather and analyze data on their employee turnover. A specific turnover analysis identifies turnover on a per-shift basis. For example, a position on a shift that is replaced six times in one year represents a 600% turnover ratio.
"The number one reason for turnover is human issues," Maun said. "It’s not about moving on down the road for a buck or two an hour more. It’s because the staff member felt they were being ‘messed with’ with by fellow staff members or by [administrators]."
Maun encourages radiology administrators to create an ongoing data analysis of their staff, including:
- Specific turnover numbers by quarter
- A quarterly or bi-annual wage, salary, and benefit survey of the competition
- A quarterly employee survey
- An ongoing customer survey of patients and other wards that use radiology services
- Exit interviews with staff who leave that should be performed three to 12 months after departure.
Maun urged the administrators at the conference not to wait for their HR departments’ annual survey to obtain this data, but rather to go out and collect it themselves.
Administrators also should look to the top talent on their technologist staff to assist them in defining the elements that keep quality staff on the job.
"The best solutions are usually found by the people closest to the problem," he noted. Once these elements are identified, administrators need to commit to supporting a department in which these elements can flourish.
"The quickest way to lose all credibility, forever, is to ask your staff what works and what doesn’t, and then do nothing to change the stuff that doesn’t work," he cautioned.
Recruiting and selecting quality staff
As part of their written plan, the 12-week team needs to create a program for "passionate orientation" of new hires, Maun said. This requires a customized, sequential checklist of everything a new hire will need to perform the job successfully and integrate with the staff -- even for matters as simple as locating the cafeteria. The new hire must successfully demonstrate these skills to a designated mentor.
A designated mentor is a linchpin of Maun’s strategy for retaining quality employees. The mentor is a trained staff member who is on a parallel schedule with the new hire during the probationary period. For every new employee who stays with the institution, the mentor can be rewarded with a quarterly bonus.
The use of mentoring ensures that new hires will not be turned loose to be trained or "poisoned" by what Maun called "CPTs -- certified professional trolls: the staff member in every department who can only see the downside of every change."
After a customized checklist and a mentor program have been created, the administrator then can begin to recruit new staff into the department. Maun strongly recommended that any employment ad contain the phrase, "call for a professional appointment," a phrase that creates a set of expectations on the part of the potential hire, ranging from appropriate dress to punctuality.
"If a job candidate is late for their interview, don’t interview them," Maun said. "There is no hiring requirement that you have to grant someone an interview. If they’re late to something as important as this, there’s a 90% correlation that they will continue to be late."
Administrators should also ask the candidate to send in a list of references before the interview. If they don’t send the references, which should be checked in advance, don’t interview them, Maun said.
Maun recommended that administrators team up with their designated mentors and perform a behavioral interview with potential candidates, using a planned set of questions. One sample query would be: "Can you describe a situation in your past job, or school, in which you could not make it in on time and what you did to resolve that problem?" This type of question provides administrators clues to a candidate's past behavior, Maun noted.
Seal the deal
Once a candidate has been approved, the department administrator should make a job-offer phone call, followed up immediately with a job-offer letter. Maun said that by following his selection process, partnering with HR from the start, and performing the background checks prior to interviewing, a 30-day hiring process can be reduced to one week.
"The offer letter, in addition to the standard verbiage, should include a note from the department administrator expressing his delight in welcoming the new staff member on board," he said.
Most important, he said, announce the new hire to the rest of the department, perhaps by putting his or her picture on the staff bulletin board. Administrators need to create an air of excitement and opportunity, both in the new hire and the staff.
"Building teams requires planning, strategy, and commitment," Maun observed. "But if you can’t commit to building a team, you might as well install revolving doors in your department."
By Jonathan S. BatchelorAuntMinnie.com staff writer
February 23, 2001
Related Reading
Radiologic technologists still search for respect in tight job market, November 6, 2000
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