There are four steps in the staff procurement process: attraction, selection, retention, and attrition. Practices attract potential staff members in different ways, but the applicants come due to a certain set of community and practice values which are perceived; these values are not the topic of this article. Selection is easier when the appropriate applicants are attracted. This article will not discuss retention and attrition, but both MUST be eventually addressed if you hire people to be developed into practice winners.
Given the high costs of finding and training new employees, you can’t afford a hiring mistake. The challenge in today’s veterinary practice is to find capable and qualified candidates who are going to stick with the practice. On some occasions we only offer a salary that lures the substandard applicant, but that is because we do not think of the cost involved with bringing them up to the level of a highly qualified applicant. We want to hire team members who extend our caring professional services, and a well planned search and decision-making system can help ferret out winners. We hire for attitude and commit to training the individual to the skill level of excellence.
The personnel agencies and help-wanted pages should be last resorts. The screening process is time-consuming and good candidates may be missed due to poorly written resumes. Instead, use the appropriate professional society or trusted colleagues for direct referrals; the advantage of this approach is that members of professional organizations are likely to be current and committed. Try to find the great restaurant hostess when filling a receptionist position or seek assistance from a nurses aide vocational school for a technician assistant candidate; this approach puts you back into first-hand control of candidate selection. Movers and shakers who are on the lookout for good opportunities will make it known to the appropriate professional organization representatives as well as continually offer their business card to the great restaurant hostess for “. . . when they get tired of the food business.” The search for excellent leads is a continuous process. The internal application file is often adequate for reception personnel if we took time to take those unsolicited inquiries and convert them to applicants because we were impressed. We need to hold on to those type files until an opening occurs.
When entering the hiring process, ensure you identify the attributes/traits needed in the practice zone where the new staff member will be working. Steer away from selection by job descriptions, those laundry lists of tasks, except as a starting point for the future; they are a charter for in-service training, not a skill list for hiring. The job descriptions seldom reflect the real practice philosophy; a list of attributes needed to be successful in the duty zone is the real success factor for most staff hires. Develop duty zone models, including performance standards and leadership expectations, that characterize the nature of the work in that zone. The zone coordinators will be accountable for dividing the duties based on the strengths and skills within the staff of that zone. The “nature of work” description should include:
- common attributes/traits of a successful staff member in that zone (the outgoing smile of the receptionists, the tenacious dedication of the inpatient nurse, the communication sincerity of the outpatient nurse, etc.) ;
- achievable results (what you would like to see the person accomplish);
- obstacles (realistic problems expected in the practice operation);
- the job environment (physical space, reporting relationships, and the pace of the practice);
- an updated summary of activities from the people who already do the functions (what type of person will augment the existing skills with new skills);
- the management, or work style, required (ability to handle pressure, stress, and delegated authority).
THE SMART WAY TO START
In the 1998 Iowa State Press text, Building The Successful Veterinary Practice: Innovation & Creativity (Volume 3), we introduced the “hiring team” concept, and discussed the topic in greater depth, but the basic premises are simply: train your hiring team (share the survey questions and job expectations), allow them to hire and conduct the training during the orientation/introductory period for every candidate (approve the training plan and schedule), and plan to get involved ONLY at the 90-day hiring decision (must have team fit and at least an 80 percent competency for the job description elements). Start the process with a physical resume “drop-off”, and trust the first impressions of the front client relations team on image and personality. Then continue with phone interviews that incorporate the key knockout questions. The phone interview can be ceased at any time and allows evaluation of phone technique and communication skills. If you had the resumes hand delivered, without an interview time commitment, your team formed a first impression before the phone calls; there are now two documented opinions (or chances for elimination) before actual interview day. Using resumes before the phone interview or after the phone interview is a personal preference that may also vary with the position being filled, so be flexible. Interviewing prospective staff candidates by phone requires different techniques from seeing them in person. But it can be much more efficient than face-to-face meetings, particularly when you have a long list of candidates to screen, or when you are selecting a new receptionist who will be your phone representative. Here is how to make telephone interviews work:
- LIST KNOCKOUT QUESTIONS. Base them on the qualities or skills you decided the job requires. The knockout questions may be emergency hour commitments, team cooperation, experience, or simply value questions. Unless a candidate responds positively to these first questions, you should end the interview — an option you can’t exercise gracefully in a face-to-face situation. If, for example, the practice has emergency call every other night and every weekend for a new veterinarian, find out right away if the veterinarian is willing to do that. If not, there is no reason to waste your time — or the applicant’s.
- PHRASE QUESTIONS NEUTRALLY. Don’t give away answers you want to hear in your questions. Instead of asking “Do you work well on your own?”, ask “Is it your style to work on your own or with a team?” Neutral questions really work better in phone interviews since there are no visual cues possible. The answers received will be more candid and will give you a better sense of compatibility.
- DESIGN A RATING FORMAT. You are more likely to confuse candidates and their qualifications with a phone interview because there are no visual memory jogs. That is why a written score is critical; one to five, pluses or minuses, or even letter grades, whatever works for you. Please note that although “yes” and “no” questions are easier to score, they tend to mask true feelings. Mix the questions to properly assess the candidates. Make your screening selection on the highest score.
- KEEP CALLS TO APPLICANTS CONFIDENTIAL. If you call people where they work, ask whether they are free to talk candidly. If not, offer to call them at home. If you must leave a message, just leave your name and number, not the practice name.
- BE DIRECT. Explain that you are calling to get more information before making the decision about whom to interview. If you get a negative response to a knockout question that is critical, stop the discussion and say that a positive answer was imperative to be considered and thank them for his/her time. If the candidates meet the essential requirements and possess the desirable qualities, simply state that you will assess the information and will get back to them within a particular period of time. This is also the time to ask them if they have any questions and see if they wish to decline further interviewing.
It is important to get back to everyone you talked to during the screening process. Phone the people you want to see; write letters to those you eliminate as candidates. Employers who don’t do this jeopardize future relationships with job candidates and their practice’s reputation within the community.
THE NEXT STEP IN THE WINNING PROCESS
After the phone and resume screening procedures, the candidates who arrive at the practice should be provided the job model. Allow them adequate time to read it and also allow them to ask any questions about the model. The conversation that follows should be a direct effort to match the candidate with the position. Both of you should be able to tell very quickly whether there is a basis for further discussion.
Another innovative approach is to use a screening team: receptionist, technician, plus one other such as an employed veterinarian, client, or bookkeeper, depending on the candidates. This team should ask questions that will elicit information about the candidate’s experience and skills. Finding out about these areas is a straight forward exercise when the team makes a list of questions based on the job model, resumes, and job knowledge (ask the same set of questions of every candidate, even if you like them as a person). If fact, since the receptionist and technician will likely be the primary trainers, making them the primary hiring decision makers is a reasonable expectation.
To determine their knowledge level is trickier. The “what if” scenarios of working situations can help uncover how much they know about their field, find out what steps they would take or methods they would apply to solve a problem. Stay away from the “yes” or “no” style questions. Throughout the interview, listen for “how and why” explanations and examples of real accomplishments.
A sample interview guide is attached for receptionists. It is scored by “+” and “-” marks and can be used by multiple people listening to the same reply. The factors included in the sample form have tried to illustrate how to evaluate a potential team member from many perspectives. The questions, and the “What To Listen For” guidelines, need to be tailored to the specific practice and the specific responsibilities that the person will assume. The characteristics of a great accounts receivable specialist will not match the traits of our telemarketing representative. In fact, we should hire for attitude first, then the specifics of the taskings at hand; a person with a proper attitude will be able to do the job with adequate training on the practice’s part.
After each interview, each team member should assign a quantitative value of how they feel the person measures up to the job model. The same priority ratings must be emphasized for every candidate. If the team is composed of a front room person (client relations specialists), consult room person (outpatient nurse), a back room person (inpatient nurse), and a business office person, the balanced harmony will help identify the top candidates. This method will also test the objectivity of each of the team members, so the discussions after completing each rating, but before the next applicant, will help confirm impressions or point up inconsistencies that need re-evaluation.
THE FINAL STEPS TO WINNING
The team screening process established the need for total work place harmony in the candidate’s mind, and established the fact that the employer trusts his/her staff to select quality people for a quality practice. This tone-setting experience makes the final steps easier for the Hospital Director or practice owner who does the actual hiring.
The client relations specialist (receptionist)/nurse technician hiring team can bring the candidate into the orientation period at a lower wage (non-productive experience time) and then meet with “Doc” to set the new introductory wage when the person is ready to go solo for the remainder of the 90-day introductory hire period. At the end of the 90-day introductory period (no benefits), the “boss” again meets with the key team members to determine the real status of the candidate’s capabilities, competencies, and team fit. If there isn’t a team fit, do not hire for skills!
The final selection, and the salary setting, is the boss’s area of best involvement. There may only be one or two applicants given to the Hospital Director for final interview or just to set the expectations of performance and empower the receptionist and technician trainers in the eye of the candidate. In some practices, there is a “hiring wage” which morphs to a team wage at 90 days based on team fit and training excellence. The probation period is clearly defined and the method(s) of performance appraisal are defined before offering the job. In the 1998 Iowa State Press text, Building The Successful Veterinary Practice: Programs & Procedures (Volume 2), Chapter 6 introduces the “performance planning” alternative to the traditional retrospective performance appraisals, but that process starts at 90-days, not during the introduction or orientation phase of employment. The expectations must be crystal clear to the prospective employee. In fact, one closing interview statement that stands out in my memory is, “If you don’t plan to sweat, don’t take this job.”
The other factor to assess is why there is a vacancy in your staff. If the practice is expanding, the answer is easy, but if an employee has left, the answer is tougher. Sometimes an exit interview is possible and will shed some light onto the situation. The reason most employees leave their jobs prematurely is that their expectations are different from their employers. If that is applicable to your practice, it is important to be realistic about the job model and what kind of person for whom you are looking.
The team must be built on factual expectations that recognize the value of the individual to the practice goals and client service. When a new staff member is hired, keep the interview notes (with strengths highlighted). When that paraprofessional or professional departs the practice, stop and evaluate the reason in light of the strengths that were recorded at hiring. If you changed the job expectations or the role that the person was to fill, then look into a mirror for the real cause of the high staff turnover. I hope you can change that person’s management behavior for the sake of the remaining team members.
HOW DO YOU KNOW YOU HIRED A WINNER?
Training, as well as hiring, should be the responsibility of the hiring team; the office manager, a nurse (technician), and a client relations specialist (receptionist) would be the new hiring team (an animal caretaker could be added if the new staff member is entering into that zone) and automatically become the training team to make the person they selected successful during training and orientation (visit the VIN BOOKSTORE website, www.VIN.com, to review the VCI Signature Series monograph, Training and Orientation, for a four phase, 90-day checklist, which is also on the monograph diskette, ready for practice-specific tailoring)! The practice leadership needs to set forth general guidelines for the 90-day probationary/introductory period (terms may vary per Province or State) and then provide the who and when of the schedule, in writing, to the staff and doctors (see examples #1 and #2 below). At the end of 90-days, team fit (harmony) and job description competencies will be evaluated by the doctors and hiring team to determine if the candidate should be hired and, if so, at what wage.
a. Example #1: Practice Guidance/Requirements for “New Staff Member Schedule” (within 90 day probationary period):
- Start person at “Trainee’s Wage” (unskilled: $0.50 to $0.75 per hour above McDonalds hiring wage) with commitment to adjust the entry wage at end of the nonproductive orientation period (end of phase 2).
- 5-10 work days — orientation to all areas (telephone, exotic care, ambulatory, surgery, lab, reception, etc).
- 5-10 work days — follow someone in proposed duty area (this can be curtailed somewhat with very experienced hires).
- 5-10 work days — new staffer does the work while the doing staffer follows (curtailment of this cycle should be only after 90% of the unique practice occurrences have been experienced by the new person).
- Staff trainers and doctors — evaluate and recycle new person through training programs as needed.
- Hospital manager and the hiring team meet to evaluate candidate’s potential to join regular team as an independent solo staff member. This group sets a new wage for the balance of the introductory period based on the performance to date and cash budget availability; this also sets the candidate on his/her new course of team development and participation.
- Commit to final hiring decision and another wage review at the 90-day point following competency, productivity, and team-fit evaluation of the candidate’s independent CQI efforts; practice owner(s), hospital manager, and the hiring team will be the decision makers at 90 days!
b. Example #2: New Team Member Orientation (schedule for first ten days):
- Day 1 — report to practice manager; learn to make coffee and follow the manager around when not reading the Employee/Staff Manual and Protocols.
- Day 2 — report to reception; watch morning reception and client admission activities (learn a little of where files and forms are kept).
- Day 3 — report to inpatient technical assistant; observe treatment room activities (learn a little about restraint procedures).
- Day 4 — report to animal caretaker; assist animal caretakers in image and patient needs (could shift to grooming during part of the day).
- Day 5 — report to inpatient nurse; get “practice special interest time” with one or two doctors (learn about “special” practice capabilities).
- Day 6 — report to reception on Saturday; watch client flow on a Saturday, from admission through discharge, from the reception area to waiting room to exam (watch for inefficiencies in client care).
- Day 7 — report to pharmacy/inpatient technician and observe the laboratory in the morning, then shift to surgery; scrub in, don cap and gown, observe surgery (learn about aseptic sterile procedures).
- Day 8 — report to outpatient nurse(s) – follow the outpatient small animal doctors around; observe inside the exam room and hear what clients are told; report to each doctor as applicable.
- Day 9 — report to practice training mentor (doctor or nurse); watch critical components of healthcare delivery program in action.
- Day 10 — report to practice manager; especially learn about discharges, then watch close-out procedures (learn importance of an accurate till).
c. It will be the staff trainer’s responsibility to shift the orientation schedule depending on the needs of the new employee as well as the workload requirements. She/he will monitor the activities of each day, regardless of the action person, so she/he can evaluate the progress and make adjustments to future training schedules.
d. A written plan for the second (follow someone) and third phase (someone follows you) of non-productive orientation is also needed. The lead trainer has this responsibility to have the plan completed and given to the doctor(s) before day eight (the day the person spends with the doctor(s) in the exam rooms) of the first ten days. Remember, the VIN Bookstore has far more than just the orientation & training schedule for receptionists and technical nurse assistants in their Signature Series monograph series, each coming with a content diskette, to allow total practice tailoring.
e. During the orientation and introductory hire period, the practice must be ready to “dehire” anyone who violates the team trust, proves ineffective after training, proves untrustworthy, or cannot adapt to the practice’s standards of operation. Releasing individuals during this time is seldom grounds for unemployment (check with local State Wage and Labor to ensure this is appropriate for your locality). Dehiring is a courtesy to everyone . . . it allows the candidate to seek a new vocational horizon more compatible to their work ethic and capabilities.