Archives for 2020

Iman Abuzeid MD, CEO of Incredible Health and David Jones, CHRO of Stanford Health Care spoke in a no-holds-barred conversation titled “How to hire and retain top nurses during COVID-19 and beyond.” It was hosted by Becker’s Hospital Review. We firmly believe that bringing some of the top minds from the healthcare industry together can help us move forward on the topics of nurse hiring, retention, and margin expansion. 

Leaders presenting on hiring and retaining nurses:

David Jones: With over 30 years of experience as a Chief Human Resources Officer, David has led several large-scale organizational change and HR transformation efforts. He has a strong track record of driving business results through the development and execution of Human Resources strategies in diverse industries such as e-commerce, financial services, academic medicine and health care. David came to Stanford Health Care in January 2017.  He and his team have embarked on redefining and transforming the HR function to fundamentally shift how HR Services are provided, how to leverage innovative technology, and deliver a preeminent employee experience.

Iman Abuzeid: Iman Abuzeid is the Co-founder and CEO of Incredible Health, a career marketplace whose custom matching technology offers hospitals the fastest, most effective way to hire qualified permanent nurses in less than 20 days (national average is 90 days). Incredible Health is on a mission to help healthcare professionals live better lives, and find and do their best work. Incredible Health is based in San Francisco, backed by top tier venture capital firm Andreessen Horowitz, and is used by hundreds of leading hospitals across the country, including Cedars-Sinai Medical Center, Stanford Healthcare, Baylor Scott & White and many more. Iman is a MD, and holds an MBA from The Wharton School of the University of Pennsylvania. 

Overview of the market for employers hiring nurses

The supply of, and demand for, nursing talent is increasingly unbalanced. The United States needs more nurses than ever to help care for an aging population. But the number of nurses has not kept pace with the demand. In fact, U.S. hospitals will face a shortage of over 1 million nurses by 2024. This trend is the largest employment crisis in the country.

We already see impacts of the nurse staffing crisis. On average, it takes a hospital 82 days to fill a permanent, specialized nurse position. Additionally, 17% of nurses leave their job every year. This nurse turnover rate is at record levels across the country.

Hospitals have adapted to these challenges by paying more overtime to their existing nurses and paying a premium for travel nurses. As a result, the overall amount of money dedicated to paying nurses’ salaries has increased. Unfortunately, the quality of care has declined at an accelerating rate. Because hospitals are understaffed, there is increased risk of medication errors and readmission rates. There is also a negative impact on nurses. Nurse suicide rates are at all time highs. More nurses report burnout, and job satisfaction is at all time lows.

How algorithms help hospitals hire nurses faster

Incredible Health built custom-matching technology hospitals use to hire high quality permanent nurses in less than 20 days. In order to do this, Incredible Health’s software collects dozens of data points from both employers who are hiring nurses and nurses who are looking for a job. Then, the algorithm matches nurses with employers who are a good match for each other. There is also a pre-screening algorithm that checks for nurses’ skills, experience, licenses and certifications to ensure they meet all the job requirements.

Another feature of the Incredible Health hiring platform is employers apply to nurses instead of the other way around. Nurses love this. They simply need to create one profile and have the power to accept or decline interview requests from employers. Nurses who use Incredible Health to find a job attain, on average, a 17% salary increase and 15% reduction in commute time.

The results of this technology-based solution is stunning. Hospitals who use Incredible Health’s matching technology increase their nurse hiring efficiency by 25x compared to traditional job boards. They also fill their nursing positions 3 times faster than the national average, in under 20 days. 

The primary challenges to hiring nurses at Stanford Health Care:

1. The nursing shortage: While all nurses are in high demand, very specialized nurses (ICU, OR, etc) are particularly in high demand. While there are new graduate nursing programs at our hospitals to help address this gap, it is insufficient to meet the hospital’s needs. In addition, we are seeing an aging nurse workforce and many of the most skilled and experienced nurses are on track to retire before the next generation of nurses is prepared to fill their shoes. The current prediction is that there will be a shortage of one million nurses by 2024.
2. High cost of living: Nurses in many of the larger cities in the U.S. face steep prices for basic necessities such as housing and transportation. For example, even nurses in the San Francisco Bay Area who make six-figure salaries struggle to make ends meet when they’re faced with a skyrocketing cost of living. 
3. Nurse leaders are highly selective: Many nurse leaders have challenging expectations around the qualifications they expect nurses to possess. Our organization often requires a BSN, years of experience, and other criteria that significantly reduces the size of the available talent pool.

How hospitals adapted to address the challenges of hiring RNs

Top hospitals like Stanford Health Care have invested heavily in building a strong brand as being a top place for nurses to work. We have achieved this by building a strong training program for nurses, obtaining Magnet status, adopting technology that improved the efficiency of the hiring teams, and paying very well. 

Hospitals who don’t have as strong of a brand as Stanford Health Care still have many levers to hire nurses. The first option is to embrace technology to help with sourcing, screening and hiring. Hiring nurses in a tough talent market is, by definition, high touch and relationship driven. But there are many repetitive tasks that can and should be automated so that recruiters and hiring managers can spend more time building relationships. 

Examples of elements of the recruiting process that should be automated include: 

• Identifying candidates who are a good fit for a role
• Pre-screening candidates for baseline qualifications
• Checking a nurse’s license 
• Scheduling interviews with a recruiter or hiring manager
• Repetitive tasks in the Applicant Tracking System (ATS)

Recruiting activities that are still very human-driven:

• Providing a candidate with a very realistic view of life at the hospital
• Recruiters and hiring managers building a strong relationship with each other to understand current and upcoming needs, the realities of the talent market, and improvements to the candidate experience
• “Selling” the nurse on the upside of working at the organization
• Screening for soft skills that the hiring manager considers crucial to success in the organization

How to improve nurse retention at hospitals 

Address work / life balance concerns to avoid burnout

The first step to creating work / life balance for nurses is to make sure we have a sufficient number of permanent nurses on your team. We use a hiring technology platform like Incredible Health to ensure we fill permanent positions quickly after there’s an open nursing position. Requiring nurses to work overtime makes a very negative impact on their job satisfaction and mental health so we plan in advance to ensure we don’t consistently ask our nurses to work extra shifts.

Create scheduling flexibility for nurses

Many nurses have numerous responsibilities in their lives besides just working as a nurse. For example, one nurse may need to take care of his/her aging parents. Another nurse may need to spend more time with his/her child. In response to this, some nurses may need the flexibility to work part time. Others may not want to be tied to working 3 days 12-hour shift schedule. Creating flexibility in our nursing schedules allows us to be a desired employer for many experienced and highly skilled nurses.

Foster nurse career advancement opportunities

Stanford Health Care is well known for an excellent career advancement program. There are several things we do that any other organization who hires nurses can replicate. First, we formalized a Professional Nursing Development Program (PNDP) and have formal mentorship programs, and special projects high potential nurses can volunteer for. We also encourage their nurses to obtain additional professional certifications.

Our leadership is also intentional about engaging nurses in decisions that determine hospital policies and procedures. By doing this, leadership can hear directly from people on the floor who work with patients and directly see the impact (either positive or negative) of new policies. By doing this, the hospital is in the 99th percentile of patient satisfaction and boasts countless awards and scores related to patient outcomes and nurse satisfaction.

In addition, Stanford Health Care has made a very intentional commitment to diversity in our nursing leadership. By intentionally focusing on diverse and talented nursing leadership, we have grown the ratio of diverse nursing leaders from 21% to 48%. We do this both by intentionally recruiting talented, diverse leaders as well as by developing and promoting the most talented leaders from within our organization.

How HR, talent acquisition and nursing can save hospitals money

First, it’s important that regardless of where team members are in the organization, whether they are a team leader or individual contributor, or in HR or nursing, that we each recognize that we’re a business leader. A hospital is a business, it has financials, there are targets, there’s a bottom line, and everyone on the team should have this mindset. In addition to providing world-class patient care, we’re also running a business.

Although some hospitals don’t have operating budgets as large as Stanford Health Care’s, every hospital can learn from our philosophy. Top hospitals take a long-term view on compensation. By doing this, we recognize that vacant positions and high turnover rates are incredibly expensive for the hospital. So ensuring we pay enough to hire and retain the top nurses is an investment that pays dividends for years to come.

As a result of COVID-19, individuals across all functions in a hospital are being asked to do more with less. Integrating technology into existing processes has provided a massive increase in savings. For example, integrating a hiring platform like Incredible Health allows hospitals to increase nurse hiring speed from the national average of 90 days, to less than 20 days. At Stanford Healthcare, Incredible Health enables us to hire experienced, specialized nurses in 21 days. This allows units to increase their patient capacity and reduces the hospital’s needs on prohibitively expensive overtime and travel nurse expenses. 

Resources for hospitals looking to hire nurses

If you are interested in learning more about hiring and retaining top nurses, Just reach out to Incredible Health here and we’d love to walk you through a free 30 minute consultation to see whether we can help meet your needs. 

Outdated Sourcing Methods Put a Hospital’s Bottom Line at Risk

The nursing shortage continues to grow in many states across the country, with California at the top of the list. According to a new study by the Health Resources and Services Administration, demand for RNs will outnumber supply by nearly 45,000 in California within the next five years. Nationwide, almost 700,000 nurses are projected to retire or leave the workforce in the next six years.

In California, almost a third of the nurse population is now over the age 50, which will only increase the impact. And that impact is significant. An article in the New England Journal of Medicine found a significant correlation between mortality and below-target staffing and high-turnover shifts, which can lead to costly litigation and damage a hospital’s STAR ratings and reputation.

Increasing the number of RNs can help hospitals improve patient satisfaction and outcomes by reducing the number of readmissions and hospital stays related to adverse events. The ability to efficiently recruit and hire high-quality registered nurses and nurse practitioners has never been more important to a hospital’s bottom line.

What matters most to nurses looking for a new position

The first step in recruiting nurses is to understand what they are looking for. This question was posed to more than seven thousand actively-looking nurses across the U.S. in a recent study conducted by Incredible Health, a strategic healthcare recruiting technology company. Of all nurses in the study who included their degree, nearly 70% had a MSN, DNP or BS/ BSN and the average experience reported by RNs and NPs was nearly a decade. The study found some interesting statistics, one being that thousands of nurses from nearly all 50 states indicated they would like to relocate to California. According to the California Board of Registered Nursing, in 2016 there were 14,381 requests for license endorsement into California from nurses living outside the state. Of those looking for a higher salary, California presents a great opportunity.

The problem with traditional recruiting methods

The process for sourcing and hiring permanent RNs in areas of high competition such as San Francisco Bay and Los Angeles can reach 90 days or more. This is far higher than the 25-day best practices required to keep hospitals at full staff or even the national average of 82 days. The longer it takes, the higher the costs incurred from overtime and travelers. For a 300 to 500-bed hospital, losses can average nearly $90,000 a day.

Most hospitals rely on hospital job boards or online job posting sites like LinkedIn and Indeed. The sites are passive and depend on candidates to reach out to the employer. While they may get job postings in front of hundreds of candidates, those candidates are not necessarily a good fit. They require hours of manual screening to vet each applicant, many of whom apply en masse to dozens of positions whether or not they are qualified. Research by Incredible Health indicates a typical hospital recruiter would need to screen 500 online applicants to hire just one person, an average hire rate of just 0.2% of all applicants screened. Hospital job boards fared little better at 2.6% hire rate to applicants screened.

Outsourcing is another option, yet, many agencies rely on the same outdated recruiting methods as hospitals do, returning similar results but at an even higher cost. With California’s competitive market, outsourcing fees can reach as high as 20% of a candidate’s salary. Given the high salary in some areas of the state, this can be as much as $30,000. The high cost and lackluster results leave hospitals with minimal return on their outsourcing investment.

Improving the nurse experience: A win-win approach

Besides being costly and inefficient for employers, traditional recruiting methods are frustrating for candidates as well. Finding the right fit at the right salary in the right location requires time-consuming research, after which they often find themselves stuck in the black hole of multiple human resource departments.

Negative encounters are, unfortunately, an all too common experience for candidates. A recent survey found nurses in high- shortage areas reported having multiple negative encounters during the recruiting process that impacted their decision whether to pursue the hospital or not.

What nurses want is an easier, more friendly job search experience. They want to know more information about a hospital so they can narrow their search to their own preferences before they submit an application. Forward-thinking hospitals and nurses are turning to technology as a way to connect, forgoing inefficient job boards altogether.

Reasons given included:

• Rude, unfriendly recruiters and phone calls
• Delayed responses
• Never heard back
• Introductory letters with typos and grammatical errors
• Uncompelling description of the employer
• Salary information given was inaccurate

Just like dating apps, recruiting technology can cut through the noise and bring the best candidate to the best hospital faster. Our recruiting technology works similarly to dating apps by collecting thousands of data points through the candidate screening process, then applying complex algorithms to identify the best matches. Nurses are able to find their ideal position faster and hospitals are able to shorten their recruiting and hiring process to under 20 days, at a lower cost. This type of “match-making” technology is especially beneficial for hard-to-fill positions like nurse managers, specialized or experienced nurses. Bringing candidate and employer together faster also starts the relationship out on a more positive note, provides a better match, and is more likely to result in lower turnover.

For nurses, a better candidate experience means they can find their ideal position faster and with less effort. They appreciate Incredible Health’s stringent requirements – only the top of applicants are accepted – which allows them to spend less time submitting applications to a multitude of hospitals, and more time reviewing hospitals that are a better match.

For hospitals, recruiting technology such as Incredible Health provides more in-depth visibility of data analytics on details such as candidate response rates, salary data, and benchmarks by geographic regions. This insight also helps hospitals and talent acquisition leaders identify areas for process improvements, something traditional recruiting methods cannot provide.

Putting nurses in the driver’s seat

To address the growing nursing shortage in the state of California, hospitals need a new approach to sourcing and hiring clinicians. With the current nursing shortage projected to escalate over the coming decade, those who continue to rely on outdated, inefficient methods do so at their own peril.

Leveraging recruiting technology like Incredible Health can help hospitals create a more candidate-centric experience. By putting nurses in control, hospitals can cut through the noise and engage with only the highest quality nurses who are already interested in their organization. Hospitals benefit by streamlining their recruiting efforts, lowering acquisition costs, reducing turnover, finding the best nurses faster, improving outcomes, and protecting margins for years to come.

We started Incredible Health to improve the lives of all healthcare workers. Whether workers are looking to find their next job, maintain their CEU requirements, or connect with other workers, we are building a strong community and platform. We also have have built an innovative platform for employers who are hiring nurses and other healthcare workers. Here is what you can expect from Incredible Health as the healthcare industry continues to evolve.

Increasing speed to hire – Software-enabled approach

To increase hiring rates and accelerate speed-to-hire, we’ve made several product enhancements:

• Automated phone screen scheduling – enables recruiters to phone screen candidates within 24-48 hours, removing scheduling bottlenecks. 
• Instant messaging – enables recruiters to interact directly with candidates after interview requests are accepted; nurses are able to reply on their phones, thereby reducing drop-offs and no-shows.
• Capturing nurses’ specific skills – gives recruiters and hiring managers more confidence in candidates’ expertise in specific specialties and supplements sparse resumes.

Delivering top-notch nursing candidates

Earlier this year, Incredible Health launched a first-of-its-kind platform offering free continuing education units (CEUs) to all nurses across the United States. Within the first week of going live, approximately 10,000 potential new candidates joined our network. This means we are able to provide a more abundant pool of talent to our clients. Click here to learn more details about 100% free CEUs.

Sharing best practices and healthcare industry information

We have the privilege of working with over 80 hospitals/30 health systems across the country, which brings us a unique ability to share best practices. In a recent study, Incredible Health data show that nursing roles in the intensive care unit (ICU) and emergency department (ED) in March and April have seen the biggest spike in demand. Click here to find out how this uptick has led to an average of 19 days to hire, and what some of our clients are doing to support nurses during this time.