Enhancing Internal Talent Acquisition Through External Expertise: A Case Study with Adventist Healthcare

Speaker 1: 0:02

Welcome everyone to today's webinar Enhancing Internal Talent Acquisition Through External Expertise a Case Study with Adventist Healthcare. On behalf of Becker's Healthcare. Thank you for joining us. Before we begin, here are a few quick housekeeping instructions. We will begin today's webinar with a presentation and we'll have time at the end of the hour for a question and answer session. You can submit any questions you have throughout the webinar by tapping them into the Q&A box you see on your screen. If, at any time, you do not see your slides moving or have trouble with the audio, please try refreshing your browser. You can also submit any technical questions into the Q&A box.

Speaker 1: 0:39

We're here to help To learn more about the content presented today. Please check out the resources section on your webinar console and fill out the post-webinar survey. If you are interested in learning more, you can use the contact us feature on the bottom right-hand corner of your screen to reach out to connect with us. With that, I am pleased to welcome today's panel Carlos Vargas, Vice President of Human Resources and Technology at Adventist Healthcare and Chief Human Resources Officer at Howard University Hospital, and Daniel Mormack, Vice President of RPO Services at Human and VP of Talent Acquisition for Adventist Healthcare in Howard University Hospital, as well as Derek Carpenter, Executive Vice President of Strategic Partnerships at Human. Thank you all so much for being here. I'll now turn the floor over to Derek to introduce yourself and begin today's discussion.

Speaker 2: 1:35

Excellent, excellent, well, thank you all so much for joining. We really appreciate you taking time out of your busy schedule. We all know how difficult it is to find an hour, so we're honored and humbled that you chose to spend it with us. I will say but before we get started understanding that our partner is within the mid-Atlantic For anybody that's been touched by the tragedy in the greater Baltimore area that our hearts, thoughts, prayers are with everybody. So stay safe out there.

Speaker 2: 2:09

But, we are really excited for this webinar. We've put a lot of time and effort, we had a lot of fun putting it together and the hope is you know, as we go through a case study with our partner, adventist Healthcare that we're going to get a couple things out of it. So we want to really let you know what led Adventus to take a look at some alternative talent strategies, how they made the decision to partner with an.

Speaker 2: 2:40

RPO and specifically with human, and then some of those key results and outcomes that we actually saw and continue to see from the partnership. So with that, I would love to have my colleagues introduce themselves. So, carlos, do you want to kick us off and go first?

Speaker 3: 3:01

Yeah, thank you, derek. I appreciate that, and thank you for inviting me to contribute to this session. I'm Carlos Vargas. I serve as the Vice President of Human Resources and Technology for Adventist Healthcare. I have done so for the last 13 years of serving as the Chief Human Resources Officer for Howard University Hospital. We're currently managing that hospital in hopes of possibly someday acquiring that hospital.

Speaker 2: 3:35

So it's been a unique privilege to do that.

Speaker 4: 3:39

Awesome. Thanks, carlos, dan. Hey everybody, my name is Daniel Mormack. I'm the Vice President of RPO Services. This is going on to my 15th year in the recruitment space. The first half of it was in supply chain logistics kind of business management. The last half has been within the healthcare space. Carlos and I have been partnered together really for about three and a half years now really working within that recruiting space, helping in Venice Healthcare as well as Howard University Hospital achieve their recruiting goals.

Speaker 2: 4:07

Awesome and for anybody that's wondering, Dan also has a nickname. He's known as the Danimal, so feel free to reach out and call him that anytime. And folks, my name is Derek Carpenter. I'm the Executive Vice President of Strategic Partnerships for Human RPO. Really, all that means it's a fancy title for a solutionizer. So I understand where organizations have gaps, challenges, opportunities within their talent acquisition function and where some of our solutions line up to address those gaps, challenges and opportunities. So I've been with the organization for nearly 15 years and it's been a privilege to serve All right. So, Carlos, could you maybe tell us a little bit about Adventist?

Speaker 3: 4:56

Yeah, actually we're based in Maryland. We have five acute care hospitals, or three acute care hospitals and two rehabilitation hospitals and, like I said earlier, we're also managing Howard University Hospital, which operates in the District of Columbia. But our Adventist system is based in Maryland and part of our growth strategy is actually to expand outside of Maryland. But we're based in here. We've got a 115-year history here locally. We've been rated as one of the top workplaces and we also have Leapfrog Safety Grade A, which we're pretty proud of.

Speaker 2: 5:40

Awesome. Thank you, carlos and folks. I'll tell you a little bit about our organization. So Human RPO at our core. We are a recruitment process outsourcing provider and for those of you that don't know about recruitment process outsourcing, it's a recruitment model that allows us to dedicate full-time resources to our partners to recruit under their brand and banner. We support those resources with all kinds of additional support and firepower, including leadership, other recruiters, process consulting.

Speaker 2: 6:25

We want to make sure that we have a streamlined and optimized process. We live in a fast food world, after all. We'll take a look at the technology stack, starting with the ATS to ensure that that is an optimized system, and then from there we'll look to bolt on other software platforms that support the goals and the strategies of our partner talent acquisition organization, as well as our partnership. We'll also look at digital recruitment marketing strategy. So how are we proliferating our jobs? Are we casting the widest net possible? Do we have an employee value proposition or a brand promise, and are we dovetailing that into our messaging and is that reflected within the overall digital footprint? And then we'll look at data and analytics and reporting. We want to make sure that we're extracting meaningful data to help us make informed, data-driven decisions that support our strategy. And if it doesn't support the strategy, then let's change and pivot that strategy.

Speaker 2: 7:31

Ultimately, organizationally, we've been around for a long time We've been around since 1996, and we've kind of seen and done it all. We've been a contingent recruiting organization. We've been a done it all. We've been a contingent recruiting organization. We've been a travel nurse staffing organization and really found a home back in 2009 as a recruitment process, outsourcing provider and really providing value-added solutions to our partners. We make about 40,000 hires per year across our 65 partnerships. Most of those are within the health care and acute care space, and the last thing I'll say is that we're most proud of our culture and our culture forward approach.

Speaker 2: 8:15

Essentially, we use that as a business strategy. It's important for us to have passionate and engaged and energetic folks dedicated to our partners as they represent that brand and banner. That's been validated by some outside groups, including the Gallup organization, so we are actually ranked as the top 35 most engaged workforces in the world, regardless of industry or size. So a little braggadocious, but also some business strategies. That's dovetailed within that as well. So what we would really like to do is get you all involved right out of the gates here, so we would love for you to respond to this poll question. So what's the number one challenge you're facing right now in regards to building your organization's workforce?

Speaker 1: 9:05

So we'll give you about a minute to respond to that.

Speaker 2: 9:09

So please take advantage and I'll ask our panelists, so Carlos, from your seat, what's the biggest challenge that you're facing and you're trying to tackle in the next year?

Speaker 3: 9:22

So our biggest challenge and I hope I think I'm not alone is employer retention. We've seen coming off the heels of COVID is trying to stabilize staff and try to build that engagement after that couple years of disruption.

Speaker 2: 9:42

Gotcha Dan same question to you what's your biggest challenge from the TA space?

Speaker 4: 9:49

Absolutely.

Speaker 2: 9:49

And I'm a recruiting nerd.

Speaker 4: 9:50

So I always think about it from that recruiter seat, that person who's making the call To me. It's always going to be the scarcity of talent available in the market for the roles that are going to most impact healthcare's business decisions and how they want to grow. So, as everything has evolved through the pandemic, where you're focused so much on nurses, respiratory therapists, as we move today, you're seeing a larger demand for radiology, you're seeing a larger demand for pharmacy, so you're kind of I wouldn't say shifting the challenge, but there's just constantly a in addition to where there's maybe not enough talent or things, that you have to constantly evolve your strategy to meet the ever-growing demand and challenge so easily.

Speaker 4: 10:28

for me, it's going to be number eight.

Speaker 2: 10:33

The number eight. Okay, perfect, all right. Well, let's go ahead and check out the results. All right, so it looks like scarce talent in the marketplace is the front runner here, and then employee retention, so kind of telling the lines that you both suggested. So any surprises here. It's nothing, that's that's surprising me. Any any thoughts? Carlos or Dan?

Speaker 3: 11:03

Yeah, that's Go ahead Dan the Danimal goes first.

Speaker 4: 11:10

We'll see what comes before, dan. We will get that horribly particular. To me it jumped out not enough internal staff to keep up with recruitment and hiring demand. I was curious to see how that one came up there. In a way, it's positive that it's lower. I always worry when you think about retention. Do our internal teams feel comfortable moving in the organization? Do they feel that they have that opportunity, career path and achieve their own individual goals?

Speaker 1: 11:34

I'd like to see that it was nice and low.

Speaker 4: 11:36

I kind of wondered if that may come in at number three or four for our top responses. That would maybe feel good. That's, you know. We're engaging our internal workforces and seeing where we can promote, help build the story for our prospective employees.

Speaker 2: 11:49

Absolutely, absolutely.

Speaker 3: 11:51

Carlos, yeah, I think I agree. I was a little surprised to see not enough internal staff, which means the internal staffs are struggling either in terms of scarce of talent or the same retention and turnover issues that a lot of our hospitals locally are experiencing. But other than that, I think I'm in the same rank. I ranked them exactly the same, except I got the scarce talent. Maybe we have more talent here on the East Coast.

Speaker 2: 12:31

Yeah, absolutely. And to your point, carlos, those are. Those are kind of hand in glove with the internal staff, right, yeah, ok, excellent. So let's talk a little bit about our partnership. So you know, we've been partnered since 2017. So for about seven years, collectively, as a talent acquisition organization, we're making 3,000 hires a year across a lot of different hiring managers, and we really have that hybrid approach where it's TA leadership. So that's where Dan comes in. We have internal Adventist recruiters that are working alongside of human recruiters as well. So, carlos, let's go back to the beginning and, if we can, I'd love to unpack this as a funnel. So you know what drove you to originally look for alternative talent acquisition solutions. Look for alternative talent acquisition solutions.

Speaker 3: 13:25

Well, initially it was purely to focus on. We just needed additional help. Quite frankly, we thought it was maybe a short-lived need, some of these hard-to-fill positions. I think when I started with the organization we were in turnover below 15% and actually my job was created as the VP of shared services, so we had consolidated all the recruitment services under one roof, and so then we had a line of sight into all our hospitals there. So it just purely started as just needed help a few recruiters to be able to source and recruit, feel hard to fill needs, and the demand just got greater.

Speaker 3: 14:15

In terms of the pressures, we started to see turnover start to increase nothing like it is, I think, in the last year or two but it continued to increase from 15 up to 25, putting a lot of pressure on on talent acquisition. And so we had to, and so we had to look at it as it needed a full-time focus. You needed, you needed people that really they could spend all their time. That's all they did Eat and sleep, talent acquisition. And I couldn't do it, and so I had to build a team that could focus on that so I could do other things. And then, you know, ultimately we had the demand on finance because of the increases across the country, trying to find recruiters to fill our own slots and then forget about leadership in those positions and then, as it became more and more sophisticated, having the tools to be able to manage those staff. So I think those are probably the top three. In retrospect that's how our evolution happened, but it was just a business need is kind of the bottom line.

Speaker 2: 15:29

Great, and so one big self-serving question here. So you guys ultimately decided RPO was was the direction that you wanted to go in? Why human?

Speaker 3: 15:43

I think for me, within the talent acquisition business, it's about relationships, and so the biggest thing was, I think, it was a culture fit. We just the human team, understood us. We understood the human team and they have capabilities. You have capabilities built in. There's a lot of flexibility there. You know, one of the things is like, you know, sometimes you need custom solutions and you know, really never said no to any type of the questions, and so you're able to configure things so and so you just kind of fit in the leadership, the strategy, all that kind of fit in the leadership, the strategy, all that kind of fit in. And so I think the number one thing would be it was a cultural fit for us.

Speaker 2: 16:32

Awesome. Well, we certainly pride ourselves on that, so that is high praise and appreciate that. So let's talk a little bit about the partnership model. We've been in a hybrid model from the beginning. We continue to be in a hybrid model and, carlos, our initial foray into a partnership was really to focus on the ED and those hard-to-fill positions, as you've mentioned. Obviously, we're doing a lot more today than when we started. What drove that evolution?

Speaker 3: 17:08

Again, I think it was sort of a.

Speaker 3: 17:11

We're actually very fortunate that we had the relationship.

Speaker 3: 17:14

I think what really expanded it was COVID, when COVID and in part part, our growth strategy so at the time it was almost simultaneous between managing the Howard University Hospital and the COVID sort of pandemic in, I think, january and February we had we had I had put my my current talent acquisition director became the business partner for Howard University Hospital, which left me without talent acquisition leadership and I came. I came to your team, asked if they could help fill that leadership Couldn't recruit at the time, recruiters were vacant and so you guys came to me with a solution around leadership and additional FTE needs, especially when we had shutdown orders and people weren't coming into work. And so that was sort of the beginning of the relationship where we expanded to some leadership and we got to the point where we are today where we've got two talent acquisition directors that are overseeing the entire system with a hybrid model with folks from the human team that you couldn't tell the difference between the two and some in-house folks that we've got as part of the team as well.

Speaker 4: 18:52

You know, Carlos, that's my favorite part when I look at this slide is on the second half, where we are today. You see the blue and the green integrated. Everybody's working together with that strong cultural fit to be able to accomplish the goals, Derek, you don't have to jump back a slide. But the previous slide mentioned 3 be able to accomplish the goals, Derek, you don't have to jump back a slide. But the previous slide mentioned 3,000 hires the past couple of years. That's a great number. It's an awesome number. Overall hires can be a little bit arbitrary to a point right.

Speaker 4: 19:14

What are we doing on the openings and for the past two years that type of collaboration and relationship has allowed us to reduce the total openings within Invenis Healthcare by 30% each of the past two years. That's significant where you're starting to make the impact and you're able to target and work that, because we have the relationship, we can really understand what is the most important to Carlos and his team so that we can help keep delivering towards those items.

Speaker 2: 19:41

Right, and Dan, you kind of touched on it a bit. You know, in terms of that integration. Talk to us a little bit about what is within the human leadership purview as compared to the Adventist leadership purview and maybe draw a little bit of a distinction there.

Speaker 4: 20:01

Almost hard to draw a distinction right because of how integrated it really is. So what our talent acquisition directors do is they work over their designated hospitals and entities to set out the strategy for those, to make sure that we understand what the most pressing needs are, how we're going to be able to recruit and impact the candidates in those markets to the best of ability, and then really work with those different leadership groups to make sure that they're understanding the recruitment model, why we're doing it, how we're doing it and really driving that true strategy, not just in the day-to-day but really kind of the overarching for the year. Where our partners here with Carlos and Jennifer really come in is to help us understand how that how we need to make our strategy work, how it integrates into the hospital picture at large. Right, recruiting is a piece of the business. There's all these different healthcare needs that are going to coincide and then how do we match up there and really being able to drive those two things kind of from that really high level hospital side to then kind of in the weeds of recruiting is really where we get most involved.

Speaker 4: 21:02

I also want to call out another piece about the culture, the two TA directors that are there. They both were able to start as recruiters on the partnership. So they've come, they've worked in the weeds, they've had their hands dirty, they've made hires, they've seen how the process works from the beginning of it all the way up into the future, I think that really highlights the commitment on both sides.

Speaker 3: 21:24

Yeah, Dan, I think. Well, we've got one that started as a recruiter first at rehab. She's now the TA director in that seven-year span. So that's, she's part of our. One of the things I also wanted to add to what you just said was at least I hope you guys feel this way. I mean, we try, you're included in all of our leadership meetings, leadership team, You're kind of part of us, and so you've got a line of sight into our strategy. I think that's at least. We don't look at you as a vendor, we look at you as a partner.

Speaker 4: 22:01

Well, what was it? A month ago, I think you and the directors were at the Maryland basketball game. Right, that just speaks to like partnership, and when I you know, one of the things I'd love for the audience to take away is that connection and commitment on both sides is what drives success right. If it feels that it's arm length, it's only going to be as successful as arm length could possibly be when it has that right integration, it just drives results to such a better level, in my opinion. So fully agree, carlos.

Speaker 2: 22:29

Carlos as a follow-up. So one of the questions that we often get asked and something that I know is probably on the mind of some of the audience members, when you do have an external kind of third party that is coming in to integrate within the health care system, there's always that question of that cultural integration. And how are they ever going to learn our culture and will they ever be part of the fabric of our organization? So obviously Dan is remote, he's not in the mid-Atlantic. Can you just talk to that a little bit about that cultural integration versus just that job specific and role responsibility integration?

Speaker 3: 23:11

Yeah, well, absolutely. What I want to also highlight too is it goes both ways, because one of the things that, when we started this out, staff gets nervous. They think, okay, now humans taking over, we're going to outsource the whole thing, we're going to lose our jobs, and that's kind of when you have a hybrid model, that's understandable. That staff feels that way. So you've got to spend a lot of time in that cultural fit. I mean, even though we have leaderships, they got to understand that their jobs are safe. This is a business strategy to have a hybrid model. We're not going to change it and your team doesn't act that way. They're not acting and performing in a way that well, okay, we're going to take that. We just want the whole entire RPO. You're working within our strategy and you support that strategy, and so I think that's and you've got to work at it. It doesn't happen. You've got to. If you've got good engagement with your teams, then they'll understand and they trust. You've got to really have a good, trusting relationship with your staff.

Speaker 2: 24:27

Agreed, agreed, and the term partnership is is thrown around a lot and it really means something. When you have the right type of connection there, all right. Well, let's, let's move on. So obviously, the market has gone through some seismic shifts over the last several years, from the COVID period to the post-COVID period.

Speaker 3: 25:10

Carlos, maybe talk about how a partnership like this allowed Adventist Healthcare to react to some of those shifting sands and some of those different things that were thrown at us over the last several years. Yeah, and Dan, you're you're going to have to help me on this one, cause I know we worked hand in hand with the team, but at the end of the day, we were, you know, we, we had, we had to create, we had, there was a multiple things that we had to do. We actually were asked by the state to open up a, a covid hospital, um, and, and a standalone covid hospital, basically an older hospital that was, uh, defunct. We had to lift that up to take patients out so we can again try to do some surgeries. But ultimately, um, as you, you see that first four surge, we had to hire a lot of people, and it says 800 people.

Speaker 3: 25:54

And that was 800 people in 18 days and there's no way you could do that with your normal process. So we had to sit around and strategize how this was going to happen and so we came up with the whole strategy of one way in, one way out, one-stop shop. So localized onboarding and badging IT access. All that had to come into one location and we had to bring in all. We were also competing. We were doing our medical assessments. We didn't want to lower our standards while we're having this surge hiring whether it be travelers, whether it be temporary workers, whether it be full-time workers. We had to come up with a way.

Speaker 3: 26:40

We were using a urgent care center to provide occupational health support. Obviously, they were flooded with patients coming in for treatment. We couldn't use them for that, so we had to do a pop-up. We developed a pop-up clinic that basically did all of that. So the pop-up clinic was doing medical assessments, all IT configuration and badging clinic was doing medical assessments, all it uh, configuration and badging and um, and that was all part of the one-stop, one-stop shop aspect of it. And, dan, I welcome you to go in there because I know I there's there's a lot of components to it, but I know you shared in the in the paint, absolutely.

Speaker 4: 27:19

You know so when you, carl, you took the first words out of my mouth right one way in, one way out. Anytime you're going through any hiring process, any items, there's areas that are going to be optimized and there's always going to be things that we want to continue to work on. And when the pandemic really started, we needed to really expand the hiring scope of the organization. It became the time where we had to really streamline and make it as efficient as possible. So maybe you could have outsourced some of the onboarding pieces or the badging or whatever we want to describe to those terms. We now had to make sure it was seamless on site. They can get the appointment they needed to. Obviously, you have different standards within the pandemic and all those pieces you had to kind of juggle around and move All. While doing this, it quickly became apparent we couldn't just have really kind of one core way to recruit. We need to add multiple ways to get people into the system and affect these items, whether that's your traditional external, internal, recording recruiting, working on the travelers to get them into the building. You get them into the process, and then what else can we do to meet the moment, while the organization can do anything it feels is appropriate for it. There, ultimately, is an audience that has to hear the message and make sure that they're reciprocal and they understand that Adventist Healthcare and Howard University Hospital are going to be the best option for them. So being able to take that back to market and tie those pieces together, so that could be as simple as working within.

Speaker 4: 28:44

Saw a question earlier about workday.

Speaker 4: 28:46

Yes, the team is fully integrated into workday, but how do we continue to update that and make it as smooth as possible If we can gain a half hour an hour, two hours back in that recruiter's day, that's that much more time to meet these very tight deadlines and continue to expand our reach. If it's something as simple as an extra incentive, an extra way that we're starting to see in the market, where maybe competitors are doing something, do we need to follow suit? Or is there another way for us to go a different direction to help stake our space in the recruitment area? So much becomes a little bit of kind of the white noise. Right, if everybody's saying the exact same thing, why are you really different, making sure that we're plugging into that right message to continue to move us forward? So the one way in, one way out is probably the overarching strategy. Then all those little pieces of process efficiency, adding recruiters in the right areas and then making sure their segment is their time, can be as hyper focused as possible as high value activities.

Speaker 3: 29:45

That's what starts to gain you the momentum and the return on investment that we were all looking for in the moment.

Speaker 3: 29:48

Yeah, dan, you remind me you mentioned Howard. I think that was sort of a nuanced challenge that we had. So we had our own challenges here at AAC, but as we we started managing the hospital, they had the same needs and desires that we had with staff, and so they were operating on a paper process and had very little marketing. They didn't have even the infrastructure that we had available but, as you might recall, we were able to at least implement an ATS for them in three months, start marketing and include them into our one-way-in, one-way-out philosophy. So we were onboarding their teams, we were doing their interviewing, interviewing, and so that was one of the aspects that we had to actually change and try to sell. Was that interviewing aspect? Was that we? We just had a corporate panel of staff that would review the all, all staff and, I think, uh, teams part of your team was included in that, but we had nursing staff that we just did it for the entire system, absolutely yeah.

Speaker 4: 31:02

Setting up an ATS in the middle of a pandemic is never easy. So yeah, three months to get the new one in there really kind of take. You know Howard University Hospital processes and procedures, integrate them into Adventist healthcare and then hit the gas pedal, start accelerating and getting that hospital where it, where it needed to go.

Speaker 2: 31:21

Carlos, you felt like you guys needed another challenge right in the in the middle of the pandemic. You thought you'd expand and and take on a little bit more right.

Speaker 3: 31:31

I know that that was. I can't believe we did it, but we did it it was.

Speaker 2: 31:36

That's amazing that's amazing, that's amazing well, anything.

Speaker 4: 31:40

So, oh good, go ahead, dan. I'll say you think about the strong cultural component, right? So we already have that strong integration amongst our team and carlos and venice that we're bringing howard university hospital into the fold a fantastic institution. How do we integrate that? So you already have that strong cultural connection. Once those things start to link together, it allows you to start to gain that momentum and that flywheel that we like to think about and talk about, and that's you're able to accelerate through those items.

Speaker 2: 32:11

We've touched upon a bunch of these items, but, dan, can you maybe speak to the three pronged approach to surge staffing? So in addition to kind of that external recruitment component, so what did that consist of?

Speaker 4: 32:27

Yeah, so you know it's in a couple of variety of areas. In the beginning of the pandemic right, we're trying to get as many travelers as we can and anybody who's going to be a good fit for the organization as fast as you can. As you start to fast forward through the pandemic and you're starting to come out of it, there's obviously going to be costs associated to that, things that we need to do to help the overall health system be in the best position it can and keep serving all the wonderful folks in the Maryland and Washington DC area. And that really consisted of our traditional internal-external program. How do we make sure that we are affecting these jobs and the most critical jobs to the best of ability jobs and the most critical jobs to the best of ability? And what we do there is we had a pretty consistent approach to be entity-wide, system-level recruitment. So think about your operating room as an example. You'd have an operating room recruiter who would work on all the different entities. There would be a different one between Adventist and Howard due to the different systems, but a lot for them to have collaboration and make sure that any candidate if you kind of draw Howard, all the hospitals are kind of circling around the district. There you created a talent matrix. So if anybody's talking, integrating, looking, we know we can find them an opportunity if it does exist within the system.

Speaker 4: 33:35

So trying to maximize that, make sure the nurses are being chaired, make sure radiology, pharmacy, you name it they have an opportunity, they're getting it. Beyond that, we're then going to start to look at how do we affect the traveler base, and there's really two core areas there. One is going to be a tier three flip pool. So I try to think about recruiting from what does my audience ask for? If we have it and we can find a way to fit that need and communicate appropriately to them, we're going to be most successful. We can't just say, hey, here's how we think the message is, the market's going to react to it. We need to meet them where they are and not everybody was ready to come back to full-time or part-time employment. Maybe they wanted to put a toe in the water. So setting up a tier three float pool to allow nurses who are maybe looking to transition back a little bit of a soft landing really get a feel for what it's like to be working at Adventist Healthcare, start to integrate into our policies, procedures, all those normal pieces. And then you're starting to reduce some of those travelers. So all of a sudden that bill rate isn't quite as high for us. They were able to help them meet their needs. Maybe their life got shifted around right. Daycare doesn't exist. They have to manage their schedule. Certain ways it's a soft landing, but also too, for all those folks that came in the door.

Speaker 4: 34:44

Well, what if they liked us and we liked them, why wouldn't we want them to be working for us, full-time, part-time, prn and really engaging that audience consistently with communication to help them understand where they were, what they're looking for today? And then, how do we impact? And really having those three buckets, derek, work hand-in-hand where, if you're looking to go full, you know your normal external, internal, great. But what if you're looking to do the traveler reduction program? How do we get them in there? What do our benefits look like for them? What do our incentives look like for them? Why does it make sense for them to convert into us? And then maybe they're not ready to make that full commitment. How do we get them into that soft landing? So, setting up recruiters into those verticals and then just making sure that the team is able to communicate efficiently. That's a lot easier said than done. Of course, recruiting wants to communicate, but being able to drive those processes, have consistent meetings Carl's touched on them earlier right, when you're meeting with leadership and you're going through all these things, when you're asking the right questions, you're engaging your recruiters in the right way. They're able to help us with that information so that we can present it back to the business appropriately. And that's really what's driven those. You know back-to-back years of 3,000 plus hires and really you know 30 plus percent reduction in openings over those two years. Carlson actually cited a pretty interesting stat when we were preparing for this Pre-pandemic, I want to say, our traveler costs were just under $2 million.

Speaker 4: 36:06

During the pandemic, I think it reached a height per month of about $10 million, so it's a tenfold increase. Today it's just over $2 million, which is a tenfold decrease. These strategies really, really worked and they were able to drive true, real-world results. So I've got plenty of work to do today. I don't think any health system is sitting there going. We're perfect, but those are the opportunities. When you put yourself in a good position, good things happen for you, absolutely, absolutely, and Carlos.

Speaker 2: 36:33

So obviously there's some lasting legacy to the programs that you set up during this period, and one of the things that we talked about as we were preparing for this was things that didn't exist before but exist now. What are some of the progressive things that you're most proud of that still persist today, that are part of this list here?

Speaker 3: 36:58

Yeah, many of them. So the three-pronged approach exists today as well. We're talking about local recruitment, international recruitment and then grow your own, and so there's not just one solution to any of this. This is probably the most difficult market I've ever seen. In my entire career of 37 years, even working in IT and other industries, this was the toughest few years I've ever seen. And so that three-pronged approach is that you've got to cast that net wide and you've got to do what you can focus on talent acquisition. Also, you've got to continue to grow your own and then you've got to bring in international talent as well. We do so on a regular basis and play that long game. As, as one of the bullets says, we're still playing that long game, even though it's not an immediate gratification. You've got to plan that out to to fill, because there's just not enough local talent to fill all the needs that we have. The other big one is we've now codified, if you will, and have a budget. We have our own clinic. So imagine HR now is running their own clinic and that clinic goes through all the medical standards. We have a one-stop shop where the employees are checking in, getting their badges, they get HR orientation, and then we also have that one single orientation.

Speaker 3: 38:35

So moving away for there's always been a push in health care sort of convenience is the main thing, and so we then create too many points of failure. So in this case we just created a center of excellence and we thought people would come, and that's what we're doing, so we have one center of excellence for all our entire system. Now we're all located in Maryland, so we're regional, but people are coming. We also have our most distant hospitals in Fort Washington, which is very close to Virginia, so there's some distance there, but we found out that that one center of excellence is serving a pretty wide population and not having to create redundant, very costly duplication of those efforts. So that's one of the things that we're pretty proud of. So we have that. It's part of our system as well, and so we also we're still offering, we have relationships with.

Speaker 3: 39:37

We're not tied to at least until we acquire Howard. We're not tied to any educational institution, and so we're struggling for benefits, and so one of the things is that we have partners that we provide childcare assistance, and that's a very important benefit to make sure we maintain flexibility. So that was something that came out of, because we had to have nurses have children too, and so if we wanted them to work, we had to figure out how we're going to care for their children while they were working, and so we were able to establish those relationships during COVID. So that's been a very effective and it's carrying on and there's been some growth there.

Speaker 3: 40:19

And our biggest challenge right now is is trying to make sure that we have the flexible benefits. We've created sort of an internal agency with a unique set of benefits and we're working really hard to try to get a variety of different schedules. It's sort of whatever works, whatever works and typically through old school sort of health care was. You know, you've got to fit into our system and now we're trying to flip it and we're trying to accommodate all types of workers and employees into our system. So I'll leave it there.

Speaker 2: 41:00

That's great. You teed me up perfectly for this next one. So one of the things that I'm sure there's a lot of systems out there that are in a similar boat. But can you talk about the specific dynamics that Adventist Healthcare was facing that really drove the need for a more formalized reduction program?

Speaker 3: 41:38

Yeah, I don't know if a lot of folks are familiar with the reimbursement mechanisms in the state of Maryland, but it's all established at a state level. Margins are very, very tight. If we break even, maybe 1% or 2%, and so once the federal aid was lifted, there's just no way our system could survive. As Dan said, 10 million a month on travelers. We had risk of closing units or not taking care of patients and closing the doors. We had to aggressively aggressively as a system, reduce those travelers. As a system, reduce those travelers. And it's tough because you know there's on the clinical side. You're going to hear all kinds of things, it's going to put folks in danger and everything else. But in our case the danger was that we wouldn't be able to take care of anyone and we'd have to close doors. So we made an aggressive approach and I think we got back close to pre-COVID levels in less than a year.

Speaker 2: 42:49

Yeah that's great, and we've talked about, I think, many of the strategies on this slide in regards to the traveler reduction. Let's go to some of the results strategies, including the internal agency, the international traveler programs, aggressive marketing campaigns. How are we able to double the amount of hires in the recent history? And what did that consist of?

Speaker 4: 43:41

Yeah, for us, you know, it's really. You know what does the market need, right? What are the nurses looking for? What's going to engage them? What's going to move them from their current space? So you think about Welcome Home, the traveler conversion program yeah, that's a fun name, right? We want to welcome them home to Adventist Health, your home, to Howard University Hospital. But really, working with Carlos and the team, what can we do to offer them the best package we can? What's going to engage them in the right way and then help them see why their previous experience with us fits into their future vision? Right, the traditional with them, right? What's in it for me?

Speaker 4: 44:13

We need to be able to answer that for these nurses and also make sure that they understood that they're a priority. Let's face it if an RN decides they want to look for a job today and they go on and deem they probably have 50 plus managers, man, that's a great opportunity to go find yourself a new job. But how do you know what anybody's doing? I go back previously to kind of the white noise. We need to eliminate the white noise.

Speaker 4: 44:35

So we had a pretty sophisticated and simplistic tracker for our recruitment team to be able to follow up with any of these nurses that were showing interest recruitment team to be able to follow up with any of these nurses that were showing interest whether it's a little bit of interest, high interest and also those consistent communications with the floor leadership to understand how they're working and building those relationships. That way we can leverage both pieces together to engage them in the right way and understand what's most important for them. We didn't hire everybody we talked to, but we hired quite a few of them and being able to meet them in the moment where they were was really the most successful thing. So our ultimate goal, derek, is not to just make it a one-size-fits-all hey, here's who we are, take it or leave it.

Speaker 2: 45:15

It's really to hear them and help them understand why the experience at Adventist Healthcare and Howard is going to be the most impactful for them in their long-term future in his health care and Howard is going to be the most impactful for them in their long-term future, and Carlos, for something like that to be effective, it really needs to be an organizational effort. It's not just a talent acquisition or a human resources strategy, ultimately. So how did you get the? Obviously, the CFO is looking at the dollars and cents, hr and nursing is probably looking at the heads, but how were you able to galvanize leadership and all the way through the organization to really adopt some change around this?

Speaker 3: 45:56

Yeah, two really big things, I think. Ultimately, the strategy we had allowed us to control every aspect of talent, whether it was travelers. We were hiring the travelers, we were setting their rates, and so we were able to reduce rates and put pressure on those to also then hire full-time workers or convert them in support of Dan's work around the Welcome Home program. And then, ultimately, it doesn't work unless you've got your CEO behind you and obviously the CFO, because there's always going to be some exception that folks are going to want to make and work around. And so the answer was no, and so they supported us the whole way. Without that leadership support that, I think there's cracks in the armor and it makes it much more difficult to achieve your goal.

Speaker 4: 46:55

Derek, 8 am every Tuesday, we were on with the CNOs going through the candidates, going through the travelers. Talk about the connection. Hey, did you reach out to this person? Hey, my manager said they reached out but this candidate didn't hear something, Making sure we were leaving nothing to chance there.

Speaker 2: 47:11

That's great. That's great, and obviously, carlos, with a $50 million reduction in premium labor dollars, that probably afforded some more opportunities for the organization, and you mentioned that the growth strategy had been put on hold, and so what have you been able to do since that time?

Speaker 3: 47:31

Yeah, yeah, Thank you for teeing that up. So now, because now our finances are, you know, hey, we struggle every day given the margins, but now we're solvent and able to get that down and then resume all the programs that COVID has basically stopped. We're working on a new tower for our Shady Grove Adventist Hospital. We're working on we just had just purchased Fort Washington Medical Center so we can resume our capital improvements there and staff improvements and so forth, kind of stabilize it Things are stabilized and then refocus our efforts on Howard University Hospital and that acquisition and so we've got a. It allowed us no more delays on that growth strategy, which is very important to us.

Speaker 2: 48:30

We want to make sure that we save a little bit of time for some of the audience questions as well. So we'll just quickly go through this, and you know there's been a lot of just amazing results over the last several years of our partnership. Carlos, I want to touch on something in the very recent history and we may have already touched on all the points, but we've been able to cut requisitions for the organization by nearly 50 percent from 2023, rolling into 2024. And it was kind of along the lines of that surge hiring sort of model. Can you touch on how you were?

Speaker 3: 49:12

able to accomplish that. Yeah, similar to, well, very good, rigid position control, because you've got to be able to make finances meet your finances, you've got to have excellent position control. So we've established that from a central standpoint to make sure each position is justified and there aren't duplications there. But the three I think the three pronged approach is still in play there. I think that's what really helped us because we were able to keep some of those. We were early on the international game. We're all struggling internationally and so we had that pipeline built early on and even though retrogression hit it, we were still receiving candidates and hires throughout the world during during this time. And so I think and then we also, we never stopped on our nurse residency program and then we never stopped on our nurse residency program and we were hiring and the human team on the talent acquisition side just really stepped it up. We were into 30%, 35%, in some cases 37% turnover, and even to meet that type of turnover is even to meet that type of turnover is.

Speaker 2: 50:41

Oh, I think we may have lost Carlos on that.

Speaker 4: 50:43

I think the internet, we lost Carlos. The internet aim there.

Speaker 2: 50:47

So yeah, the perils of live broadcasting.

Speaker 4: 50:51

I would to finish his point. You gotta know where he was going there Really being able to meet the moment in some of those higher turnover areas, engage with those leaders, talk about what makes their unit unique, really be able to work, you know, hand in glove on the HR team and the onsite business partners working to reduce turnover and then on the recruiting side, making sure that we're keeping those jobs top of priority. That allows us to continue to grow and hit those objectives. And, derek, just to kind of put a finer bone on it, I would say, as we came to this year not resting on our laurels. So I mentioned earlier we had done a system-wide approach. If you're the OR recruiter, you're covering all the ORs and that worked and we really, really drove jobs down.

Speaker 4: 51:31

As we came to this year, we reallocated the team to be more entity focused. We kind of hit a little bit of bedrock. We're in the hardest to fill, most difficult areas. That's where our jobs currently exist, so tying them to those entities to make sure the message is as tight as possible. The managers with the hardest to fill, most challenged areas are getting absolute maximum support. So it's not as much of a volume play today as it is really being dialed in on that high, high quality to be able to achieve the right results. And I can tell you the hiring pacing looks excellent compared to year over year, which we love to see. Our fill rates up, our time to fill is going down with it, so it looks to be an early winner for the strategy. Just not kind of rest and say, hey, we did it before, we'll do it again, continuing to do a haul Great.

Speaker 2: 52:18

And I know that Carlos is efforting getting back in. So let's, if we want to go to some questions first. I know that there's been some questions from the audience. We have about seven minutes left and we will answer where we can and defer to the CHRO once he returns, but maybe we can start answering some of those.

Speaker 1: 52:41

Yeah, thanks so much. Thank you for that amazing presentation. Let's dive into a few questions. Sure, Our first question here is is the human team fully remote from Adventist healthcare sites?

Speaker 4: 52:55

We are today. We don't necessarily exclude Maryland for hiring recruiters but currently we are. We do do a fair bit of travel up for hiring events. The leadership team is going to come on site for you know whether it's the performance reviews, president's councils, things of that nature. So we do a fair bit of traveling but in terms of the recruiters that are currently today all remote, that can always change as staffing changes.

Speaker 2: 53:20

Yeah, and I'll just as a follow-up to that, should a partner request some local presence, we do our best to match up our remote recruiters. We have a fairly sizable remote workforce, so where it makes sense we will have some on-site presence. Most of our partnerships are fully remote, but there are exceptions to that.

Speaker 1: 53:44

Great. Thank you both. Our next question here is a bit of a two-parter. First part is can you share some metrics on how fast you fill positions for leadership teams? And the second part is what's your strategy in terms of interviewing Sure?

Speaker 4: 53:59

So I can touch on some of the time to fill metrics here. So overall, for just all of our positions, we're sitting at a 51 days day. That's both external and internal. When we go to leadership it comes in at about 70 days. Our leadership metric is going to run from manager through vice president. It does exclude executive leadership just due to the more unique nature in those.

Speaker 4: 54:21

In terms of the interview strategy, it's always nuanced with leaders right. There's usually a lot of voices that need to lay an opinion there. We try to do panel interviews tied together within a day or two. That way the candidates coming in they're getting a really good experience. We're able to get back to them in as fast of a time as we possibly can. If there's relocation involved trying to get them out to different neighborhoods, school districts things are going to be impactful to that individual to make sure that we're, you know, meeting them for their needs. But the goal is not to create an overly long process unnecessarily. Sometimes life can dictate that on the candidate's end RN if you're around the holiday season. But really the goal is to be pretty tight with candidates over a one to two week period, but not having them come in and out multiple times trying to keep them there for a day or two. There's always exceptions, but the more you're highly engaged, the better off. I think you are versus a long-term engagement.

Speaker 1: 55:19

Great Thank you. Our next question is how do you manage recruitment competition locally?

Speaker 4: 55:26

So I think that's going to reference maybe different health systems and things of that nature. So that's where having the integrated partnership I think is so critical, where we have recruiters on our team who are employed by Adventist Healthcare, so we can always kind of keep up with the Joneses, understand what's going on in the marketplace, how the competition's reacting to things. We also at Human have an amazing marketing team that provides us with a pretty significant amount of data tied to not just nationally but also into those local markets to make sure that we're keeping up and we're kind of staying on the forefront there.

Speaker 4: 56:00

Really a lot of our strategy isn't necessarily to match what somebody else is doing, because all we're giving them is two options of the same thing. We really want to try to stake out our own unique approach to it, to meet them where they are.

Speaker 2: 56:14

And it's important to do research and understand what everybody is doing in the market, to understand the supply and demand characteristics. One of the things that we always say it's a different recruiting effort in Chicago than it would be in Del Rio, texas, and the nuances are really important to understand those geographies, to understand the characteristics of the talent pool there and to develop specific strategies around all of those dynamics.

Speaker 1: 56:45

Interesting Thanks. Our next question is how is ROI for the partnership measured?

Speaker 2: 56:59

for the partnership measured. Yeah and Dan, I'll kind of take the first part of this and maybe you can fill in the gaps. But it's really important, as we go into a partnership, to have the right business case in place. And what are we solving for with a partnership? And typically it's well. We need to hire more people more quickly and, as a result of not hiring more people more quickly, what's happening within the organization that we can start to impact?

Speaker 2: 57:26

So we talked a lot about premium labor. So if you have open positions, you might have more traveler usage, you might have more overtime usage, you might have more special pay or shift differentials. Let's ensure that we're looking at those things. And if we go out and we hire more people and we do it more quickly, is that going to ultimately impact the ROI in a very positive way? We also need to look at, you know, if we have staffing shortages. Are we closing beds, are all our suites being closed and are we able to reopen those? So it's very unique based on every partnership, but it's important for us to understand what those dynamics are. And much of the ROI will center around the dollars and cents due to unfilled positions. But then also we want to make sure that we're adhering to the hiring volume, that we have the right KPIs and SLAs that are baked into the partnership. So if we go out and do everything that we say that we're going to do, the result to the overall organization and the institution should be very favorable.

Speaker 1: 58:41

That's great, thank you. I love the idea of you know asking yourself what are you solving for for these types of partnerships? So we have time for one more question here. It says what is the advantage of utilizing an RPO versus a managed service program.

Speaker 2: 58:59

Yeah, and it's all a matter of focus, right, and at the end of the day they're different models. Typically a managed service provider hey, carlos is going to focus on kind of that temporary staffing. They might focus on some permanent hires. But from an RPO perspective, we are dedicating recruiters. They're integrated and entrenched within the fabric and the culture of that organization. So we can truly understand that organization at a very intimate level, that we are an extension of that team. And you know, at the end of the day we want to blur the line completely. So we are not an RPO provider, we are an extension of the internal talent acquisition function. We just happen to bring all kinds of additional tools and resources to that partnership. We just happen to bring all kinds of additional tools and resources to that partnership.

Speaker 3: 1:00:02

So, Carlos, do you mind if I just kind of tail into that?

Speaker 3: 1:00:04

Sorry, I dropped off, that's okay, of course, because I know if I was taking this or listening to this, at least from where I sit, it's like why do you go to RPO? For me, the biggest reason is performance. At the end of the day, I look at and I run the calculations. I chose a hybrid model for my own purposes because I just like to have redundancies in place, and so maybe I'm paying more to have a hybrid model in place just for that redundancy. But second is the tools that they have to manage the team that a lot of us in HR just don't have. And then so, by example, in terms of performance, if we were to go back to all in-house recruiters, we'd have to hire additional eight FTEs, including the team that we have now. So we would bring in all the FTEs and add another eight. That's the level of performance difference that we're talking about. So it's pretty significant. So I just wanted to leave that there. I'm sorry I got dropped off, but I thought that was an important piece of just share.

Speaker 2: 1:01:25

And.

Speaker 1: 1:01:25

I'll just say that.

Speaker 2: 1:01:26

I think and I'll just say Riz, I think there's been a lot of additional questions that have been asked. Sorry, we didn't get to all of them. We will respond to everybody and specifically answer all of those questions. Should you have anything else or would you like, if you would like to contact us, please don't hesitate to do so. We'll be here and ready to answer any questions that you may have.

Speaker 1: 1:01:52

Fantastic. Well, that is all we have time for today. We want to thank Carlos, daniel and Darren for an excellent presentation and HUMN for sponsoring today's webinar. To learn more about the content presented today, please check out the resources section on the webinar console and fill out the post-webinar survey. If you are interested in connecting further, you can use the contact us feature on the bottom right-hand corner of your screen to reach out to connect with us. Thank you for joining us today and you'll have a wonderful afternoon.

Speaker 4: 1:02:23

Thank you everybody, Take care everybody, Thank you.