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California now leads the country in the nursing shortage with an estimated 45,000 deficit within the next five years.(1) The impact of the shortage on care quality cannot be underestimated. According to the New England Journal of Medicine, there is a direct correlation between mortality and below-target staffing and high-turnover shifts. Increasing the number of RNs can help hospitals reduce the number of readmissions and hospital stays related to adverse events.(2)

The nursing shortage also has a significant impact on the bottom line. A 300 – 500 bed hospital can expect to lose $90,000 a day just in recruiting costs.(3)

Maintaining a full staff of highly qualified registered nurses and nurse practitioners requires hospitals review their current sourcing processes. Incredible Health, a strategic healthcare recruiting technology company, suggests hospitals flip the script on their approach. Instead of focusing solely on filling positions, they should focus on finding nurses already interested in working for them.

Incredible Health offers the following four guidelines to help hospitals improve their sourcing efforts.  

1. Understand what nurses want
A recent study conducted by Incredible Health asked this question to more than seven thousand nurses across the country who were already looking for a new position. The top two answers were a higher salary (46%) and career advancement (31%).

Surprisingly, 23% reported wanting to move to a new location, with California as one of the top destinations mentioned. Statistics from the California Board of Registered Nursing backs that up. In 2016, they received 14,381 requests from nurses living outside California for license endorsement into the state.(4)

2. Eliminate inefficient, outdated sourcing methods
Hospitals that rely on job posting sites like LinkedIn and Indeed, or their own website, are not getting the best return for their efforts. They may allow you to cast a broad net to potential candidates, but finding highly qualified candidates requires many hours of sorting through resumes and on phone interviews.

Just how ineffective are these job boards? According to research by Incredible Health, a hospital recruiter would need to screen at least 500 online applicants to hire just one person. That’s an average hire rate of just 0.2% of all applicants screened. Hospital job boards did only slightly better at 2.6% hire rate to applicants screened.(5)

3. Question the value of your outsourcer
Many agencies also use job boards as their primary recruiting method, returning the same results but at a higher cost. In California, fees can easily reach 20% of a candidate’s salary, or up to $30,000 in the state’s higher-salary areas.(6)

Using agencies also means the hospital loses control of the process and has little means to ensure they’re being represented appropriately to candidates. A survey of nurse candidates in high-shortage areas found many have had multiple negative encounters with recruiters – negative enough to make them eliminate the hospital from their search.(7) The nurses reported things such as unfriendly recruiters, delayed responses, uncompelling descriptions of the employer, and incorrect salary information.

4. Consider candidate-centric technology
Traditional recruiting methods are frustrating for candidates as well. It’s difficult to get an accurate picture of a hospital from online job sites. It takes hours of searching, submitting resumes, and waiting for call-backs. Even when contacted, it’s difficult to know if the position is a good fit based on a single conversation.

New technology now exists than can weed through the noise of traditional job searches, narrowing the field of desirable hospitals early in the search process. Just like dating apps, recruiting technology such as Incredible Health collects thousands of data points on both hospitals and candidates via a comprehensive screening process. Sophisticated algorithms are applied to the data to find the “perfect match” for both the candidate and the hospital.

With Incredible Health, hospitals can dramatically shorten their recruiting and hiring processes.

• 28 days: Average time to hire nurse leadership
• 14 days: Average time to hire staff nurse

Getting Ahead of the Nursing Shortage Through Innovation and Technology

There are approximately three million nurses in the U.S., 700,000 of which are projected to retire or leave the workforce within the next six years. Filling these vacancies will require more than one million new registered nurses.(1) Even today, nearly 200,000 nursing positions sit unfilled at any given time.(2) One thing is certain: If our existing recruiting methods can’t handle today’s shortage, they aren’t going to handle tomorrow’s.

​The problem with traditional recruiting processes

Most hospitals depend on online job posting sites such as Indeed, LinkedIn, Monster, and their own job board. Yet this approach is resource-heavy, time consuming, costly and ineffective. Based on research by Incredible Health, a tech-enabled, data driven, healthcare career marketplace, a typical hospital in a busy urban area would need to screen 500 online applicants to identify just 50 potential candidates leading to the hire of just one person. That’s a hire rate of just 0.2%. Hospital job boards are only slightly higher at 2.6%. (3)

To address the shrinking candidate pool, many hospitals have begun offering elaborate sign-on bonuses, some reaching as high as six-figures. For rural hospitals with fewer candidates, the challenge is even greater. Convincing candidates from urban areas to relocate to a small town can be difficult. In response, some hospitals have begun offering free dorm-type housing for candidates who don’t want to move.(4)

Outsourcing can be an appealing alternative for hospitals with limited recruiting staff. But handing the process over to a third party can be costly, especially in today’s competitive environment. It is not unheard of for agencies to charge up to 20% of a candidate’s salary, which can be as much as $20,000 or more per hire.(5) Outsourcing also carries an element of risk as hospitals give up control of the candidate experience. In a recent study of nurses in high-shortage locations around the U.S., respondents cited everything from poorly written introductory letters to unfriendly reps to delayed and even a complete lack of responses. Several said the reps did not present the offer or the company in a positive or compelling manner. For many, the negative experiences were enough to impact their decision.(6)  

The cost of inefficiency

A 2016 report by Barclays indicates the average 300 to 500-bed hospital loses nearly $90,000 a day when understaffed.(7) By increasing the number of registered nurses, hospitals stand to save up to $3 billion from reduced hospital stays and adverse events.(8) According to the Safe Staffing for Nurse and Patient Safety Act, suboptimal staffing levels also increases readmissions, which Medicare estimates at $26 billion a year overall.(9)

In addition to increased costs, studies show a significant correlation between low staffing, quality of care, and mortality as well.(10) When positions remain unfilled, existing nursing staff have to work to fill the gap, taking on additional shifts and working longer hours. When quality suffers, so does patient satisfaction and a hospital’s HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) Star Ratings.

Taking a page from dating apps
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Technology has transformed the way people connect. Rather than relying on family, friends or chance to identify an ideal partner, individuals can now turn to online dating apps. To use the app, members create profiles and indicate what they find most desirable in a partner. The app’s algorithms sort through multiple data points in the member database to identify ideal candidates. Users are presented with only those best meeting their criteria and who are actively looking. By eliminating all others, users can find their ideal partner faster and with less effort. Today, one in three marriages begins online.(11)

Incredible Health takes a similar approach to healthcare recruiting. Through its proprietary screening technology, Incredible Health is able to quickly identify the best matches for both a hospital and a clinician. When recruiters from multiple hospitals sends interview requests to candidates, the candidate gets to decide which interview to accept or decline. Its extensive, dynamic database of experienced nurses includes 58% with specialty experience like ER, OR, Critical Care, L&D and Cath Lab, and 16% are experienced RN managers and directors. The average tenure is 12.9 years and all nurses hold current state licenses and certifications. Requirements to be included in the database are stringent; only the top 25% of nurse applicants are accepted.

Today, 60% of California hospitals use Incredible Health to help find registered nurses.

Proven Success

A large health system in the greater Los Angeles area had more than 150 nurse and nurse leadership vacancies across its six hospitals. Best practice for filling positions necessary to keep hospitals fully staffed is 25 days; however, the health system was experiencing 70 days or longer, especially for hard-to-fill areas and nurse leadership. The health system chose to partner with Incredible Health to improve its sourcing and hiring processes. With just one hour of training, the recruiting team at the health system was up and running. The results were fast and significant:

• Nurse staff positions were filled within 14 days
• Nurse leadership positions were filled within 28 days
• Hard-to-fill positions were filled, including OR, ED, NICU and nurse leadership

Not changing is not an option
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“Insanity is doing the same thing over and over again and expecting different results.” This famous quote can easily be applied to the healthcare recruiting process. To protect hospital revenue and ensure quality outcomes, hospitals and health systems need to take steps now to get ahead of the quickly escalating nursing shortage.

Leveraging technology like Incredible Health can help hospitals flip the script on the recruitment process, dramatically shortening their sourcing and hiring cycles with better results, less effort, and reduced cost per hire.

Sources
 
1 https://www.theatlantic.com/health/archive/2016/02/nursing-shortage/459741/
2 https://www.careerbuilder.com/share/aboutus/pressreleasesdetail.aspx?sd=12%2F3%2F2015&id=pr924&ed=12%2F31%2F2015
3 https://www.incrediblehq.com/employers_howitworks.html
4 https://www.statnews.com/2017/09/13/nurses-shortage-hiring-incentives/
5 http://www.nsinursingsolutions.com/Files/assets/library/retention-institute/NationalHealthcareRNRetentionReport2018.pdf
6 https://www.researchgate.net/publication/9086632_Recruiting_nurses_the_problem_is_the_process
7 2016 Barclays US Healthcare Facilities Outlook Report
8 http://ana.aristotle.com/SitePages/safestaffing.aspx
9 https://www.congress.gov/115/bills/hr5052/BILLS-115hr5052ih.pdf
10 https://www.nejm.org/doi/full/10.1056/NEJMsa1001025
11 https://www.technologyreview.com/s/609091/first-evidence-that-online-dating-is-changing-the-nature-of-society/