Speaker 1: 0:01

For those of you not familiar with Human, we started Human as a standalone RPO business in late 2016. Prior to that, we were part of a larger travel nursing business. We recognized an opportunity to transition into value-add relationships, not just be the necessary evil that traveling was, and so we took what was a very small portion of that business, sold that business off and really spent all of our time and energy over the last eight years trying to bring our RPO solution to life. We primarily spent our time in healthcare even today. We started this business, so all of our customers are in healthcare even today. We started this business, so all of our customers are in healthcare. Now about 65% of our partners are in the healthcare space. We've been able to translate the work that we do in hospitals and the non-clinical side into commercial areas and into enterprise large organizations, so that's been an exciting new feat for us. But, as you can tell by our stats, we hire a lot in health care. So last year we made approximately 42,000 hires on behalf of our partners and about half of those are RAs. That is the primary reason health care organizations reach out to us. It's always our starting point how can you help me with RNs and then the intention over time is to partner and expand that relationship to provide further support for their clinical and non-clinical needs. We're really proud of the work that we do. We have some KPIs that we hold ourselves to really high level of standard. The idea, as you partner with us, is that we have this baseline of standard and we work with your system to achieve those same levels of success standard and we work with your system to achieve those same levels of success. We are really proud of the partners that we work with. 12 of our partners have been with us for more than six years and Bob represents one of those groups. We just completed our most recent survey and received a 9.8 NPS for over 36 unique organizations. That ranked us so very proud of those results.

Speaker 1: 2:06

So why do people call us? So? We get called for two reasons. The first reason is someone has an immediate issue that they are trying to overcome. We see this a lot coming out of COVID and the pandemic and we have health systems and financial crises because of the premium labor expenses that they endured during that time period. So a lot of times the phone calls we need your help to reduce premium labor or we have a vacancy issue, whatever is going on that has made their job opening search, and so we can come in and help augment your existing talent acquisition function.

Speaker 1: 2:45

I'll show you about some of the ways that we go about that, but we are always trying to take the relationship beyond the HR relationship, so similar to what was being discussed in the prior panel, and how can we align the work that you're doing with your financial incentives as an organization partner with your CFO, and then take it a step further, and how we partner with your COO or your operations function to really institutionalize what is going on. So that way it is no longer something that HR alone is pushing, but it really becomes a business-wide initiative. We track these stats incredibly closely. This is just in the last few years these are four of our largest partners that all these numbers have been verified by their CFOs and what we were able to save them so that savings does include the full cost of our program as well has been factored into that. So that's one reason people partner with us.

Speaker 1: 3:40

The other reason people partner with us is they're in seats like yours, really trying to think long term and strategically about how they can transform how their talent acquisition, function works. These are usually individuals that have 10-year plans, are looking at their upcoming turnover, retention challenges, aging, population and business development plans. This is our most exciting partners to be in. It's really where we think we can be the most beneficial. We get to truly help revolutionize what is happening in your organization. Again, we'll talk a little bit about how we do that in a second, but Bob is going to tell his story about our partnership and why he originally engaged us and what the results were as a part of that, and his vision, which dates back well ahead of the pandemic, and how he wanted to get ahead of what was going on with staffing.

Speaker 2: 4:43

So just a little bit more about myself. I know I introduced myself as the former head of human resources for the University of Chicago Medicine. Actually, my background over the course of what was 42 years spanned a variety of industries. Most of my background in HR has been for for-profit organizations, any industries like financial services, manufacturing, consumer goods, life sciences, private equity so I had a lot of experience outside of non-profit. This was the first opportunity that I came across towards the end of my career.

Speaker 2: 5:25

I'd have to say that it was probably I am envious of many of you who have been in this field for many, many decades. In some cases, for as long as I can remember, nobody in healthcare would really talk to you unless you were from healthcare. It was a very insular industry and I was fortunate to come across a CEO who thought very differently, had lots of experience, of course, in health care, but saw the value of people outside of health care and for certain, you know, I wasn't doing any surgeries or anything but things like supply chain and HR and those kinds of things Things like supply chain and HR and those kinds of things. So I was able to bring much of what I learned over the years to health care. So when I think back at the partnership, having been there 10 years, the two things that Sarah describes is the reasons why people do business with them I think I fall into both of those categories.

Speaker 2: 6:29

Frankly, it started out with a problem. I was with the organization maybe two years and things were apparently they were going somewhat well. I thought. I looked at lots of the dashboards and numbers until one day I got a call from the head of our ambulatory operations, who I had a very good relationship with but was very direct and said to me oh Bob, you're killing me with the staffing and I'm like you know what are you talking about? I get all of these great reports. She said well, we don't have staff for the clinics, and so that was sort of a wake-up call for me, knowing that I needed to do something pretty dramatic.

Speaker 2: 7:19

And so when I thought about the current state of our talent acquisition and gave a lot of thought to that, it was pretty primitive in many ways. So, for example, the idea of recruiting at University of Chicago Medicine was recruiters carrying, you know maybe 100 or so recs. We used CareerBuilder as our main source and our recruiters would pull resumes from CareerBuilder, pile them up, walk into a hiring manager's office and say who would you like me to call it? And so they were almost giving a sort of a homework assignment to the hiring managers, who would go home, like a teacher often does, and grades tests. They would sit home and they would review resume after resume and come in and they were very much a part of the process.

Speaker 2: 8:15

So when I decided we needed to do something different, I was aware of RPOs I never had worked with them before, but it was aware, certainly, of what they do and I spent a lot of time researching a variety of different companies big ones, small ones and I sort of accidentally came across Youman's website one afternoon and I was intrigued by the quality of the website, particularly things that they talked about, like the culture of their organization. So they made it fast forward. They made it as part of the cut of companies that we asked to speak with and from that point forward, you know, I was still very hesitant. I was not necessarily I would characterize myself as not necessarily a believer and I was nervous as hell because here I am turning over the, you know, the responsibility of bringing talent into the organization as the CHRO, and what if that thing sort of crashed in Burke? So I wanted to take baby steps and so the first description that Sarah said about solving a problem I needed to solve the ambulatory problem. And so we had 50 jobs open and, after going through the due diligence of all these companies, having visited their facilities down in Florida which to this day I think it was sort of staged in terms of how they set things up, because people were just like smiling from ear to ear. They were so engaged and the culture just sort of hits you as soon as you walk through the building. As soon as you walked through the building, but that sort of not only was it true, it sort of manifested itself over time in the team that they pulled together for us and many of those people who are still servicing the University of Chicago Medicine are still on that account. So there's a lot of consistency in terms of the team.

Speaker 2: 10:22

So we decided to partner with them 50 jobs and I think the first weekend that they put out some sort of a blast, there was thousands, maybe 3,000 applicants for those 50 jobs and the understanding when we partnered with them was that we would take baby steps, we would prove ourselves that we could do this. I get more comfortable with who they are and how they operate. But if they delivered, we would expand the partnership over time. And so the first 50 jobs, they nailed it. And then I had a decision to make. I had a decision who? I sat with the CEO at the time and said, okay, so now we want to expand the partnership. Do we go big or do we play it safe? Do we give them the largest business unit, if you will, of our patient care services or do we play it safe and do a smaller unit? And, of course, the CEO said let's go big. And so we moved on to patient care services. They started to do a lot of the clinical roles. Then we moved on to administrative jobs and just kept growing the business. We then brought on onboarding. They did our onboarding or are doing the onboarding them. They've done some leadership roles, director level roles. They've also done some executive roles.

Speaker 2: 11:57

Now, throughout this partnership and I use the term partnership because that's really what it was it wasn't a vendor relationship. To me, there's a big difference between having a vendor work for you versus having a partner Partners. We all know both our personal lives and professional lives are people who think of yourself before they think of themselves, of you before they think of themselves, and that's been the relationship with Hewitt. It's how do we solve problems together. I always felt that my issues, my problems, were their problems, and it takes a lot of work to build that partnership. It takes a willingness from both parties, but that's what has evolved over the years.

Speaker 2: 12:47

And so, you know, fast forward, nine years later, they're still at it. They're posting tremendous numbers and they've got a cross system in place, which we never had, and we eventually changed out our recruiters For them. They became an extension of our team. They would come to Chicago, we'd have our business review meetings, we'd go to White Sox games. We treated them just like, you know, our employees well into the partnership, and so, unlike many of my peers who lost a lot of sleep during that period, I slept better, always had one eye open, never took my eye off the ball, but I knew that we had the processes in place, we had a consistent team of people and they continued to post, you know, large numbers. They were hiring almost 5,000 people when I left, and it took a little longer for them to do that because we were all sort of fishing out of the same pond. But you know we made it through a lot better, I think, than many of my peers. So it's again one of the best decisions I made.

Speaker 2: 14:18

And the other thing I'd just leave you with is the hiring managers. For me was the sort of the bellwether. That's what I kept very close, paid very close attention to, was the hiring managers and their level of satisfaction with the process and with the recruiters. And whenever there was an issue and very rarely was there, most of the issues were when you had the audacity to promote people and take them, move them along. The hiring managers are like what am I going to do, you know? But the fact of the matter is, you know, it's been, it's been a great relationship and you know some people go full bore right out of the gate. We did the approach that I described and it worked well for us.

Speaker 1: 15:08

Thank you Great. Yeah, and listen. We love partnerships like this because, ultimately, what we're trying to accomplish is what you're trying to accomplish, right. We are trying to create systematic, sustainable workforce solutions. The healthcare industry has come a long way, but boy does it have a long way to go, as we know, and I think part of what we try to bring into this is sort of a consumer mindset, and so some of what we're going to talk about you've heard in the earlier sessions. There's going to be some themes here, but all of these areas, if you were to ask me sort of what does your program look like, it basically looked exactly like this of how we get started. But the reality is, each of you can access in this way today and a lot of times when people are partnering with us, I think they think I have this magic wand that just produces miraculous candidates out of nowhere. In actuality, we just have a very systemized process. We have uncovered every opportunity to stop the bleed. So where are we losing people? Where is fall-off happening? Where can we refine experience? And by taking that approach over and over again and not letting the subjective get in the way of the objective are how we put up these numbers and how we get our partners from being in a constant state of reactionary crisis type of response into proactive, strategic thinking. So the first thing is you have to understand your reality. We'll talk about that a little bit. Have to understand your reality We'll talk about that a little bit.

Speaker 1: 16:53

It's interesting to me some of the conversations out in the market today. How many of you feel like last year you could breathe a sigh of relief in hiring right Show of hands? Was last year better for you than prior years? All right, let's look at some numbers and show why that concerns me. Right, you also need to know your personal numbers. We all have these incredible workday isoms, amazing ATS systems. There's so much data in there. Do we know what to do with that data and how to take action from it? You need to define your needs and so what is it that you need to do in the next year to overcome whatever your challenges? Your vacancy rate how many FTEs do you need by the end of the year? Do you know how to do that work? Do you know how to calculate those numbers? Do you know how to do it over five years and 10 years? That's, honestly the first thing that we do in our partnerships is tell you how many annual hires you're going to need. And then the last thing, really know your gaps. So we'll look at something on a talent acquisition maturity model. I have a QR code available you guys can scan into all this stuff and take it all home with you.

Speaker 1: 18:02

But it's interesting to me how many times I'm in a conversation about innovation, because that's a strategic priority for your business, but we don't have standardization first, and so it's very difficult to innovate if there is not a standard way of behaving. And I think one of the challenges we have in HR within these health systems is these businesses have these robust plans for introducing AI and introducing technology. Well, it's really easy to do in patient services, where all the money goes and all the investments have been for 20 years to be able to improve that experience. But we know what your funding looks like, right. We know that the same time and attention hasn't been spent and investments haven't been made in the HR, so you're starting from behind. So how are you holding the same standards as your counterparts in other areas? How can we get you there and make your business case for proving what has to happen first?

Speaker 1: 19:00

So we're not going to go through all of this data, but when I talk about understanding your reality, I mean actually do the math on the data. So when we look at something like our in turnover year over year, I am so glad everyone's breathing a sigh of relief. It's great we're not posting 27% turnover like we were a couple years ago at a national level. Great we're down to 18%. The amount of ties have been a conversation this year that were at pre-pandemic levels. Do the map on 18% versus 15.9% across the amount of individuals that make up that group? It is hundreds of thousands, is what it starts to add up to Vacancy rate we have. I mean, some of these.

Speaker 1: 19:50

2024 is still a projection, it hasn't fully been analyzed yet, but I think we know it's going to be less than last year. Some people are saying it's going to be 8%, but 8%, 9%. Why do we want to start with a vacancy issue? Why aren't we solving it before we know that we're going to continue to have increased job orders, et cetera. Going to continue to have increased job orders, et cetera.

Speaker 1: 20:11

Drilling into what each of these numbers mean, not just for your system but for your market, for your region, those are really important, because I think so many times we think percentages and they seem better, but are you equating it to the actual volume and quantity behind it? And then the other thing that I think is something real for us all to look at right now is a lot of position control was put into place last two years. We all played a numbers game. Great, I think the exercise of evaluating job openings is huge and something that should always happen. How is it that the active job openings for RNs only represent half of the vacancy population? So when we're thinking about job openings, yes, they've come down, yes, we have satisfied some of the short-term demands that we have, but we're still not even hiring and even marketing half of what our actual needs are. The most important thing for me on understanding reality is then how do you know what your true baseline is so that five years from now, when you're hearing stats about additional needs, when you're sitting there with your CFO and they're talking about the expansion plans, you're like now I have another 2,000 FTEs to account for it, 50% of this unit's going to retire you have a realistic baseline to work from and then you can add on those future stats that you know are inevitable to fall into your workforce needs.

Speaker 1: 21:43

There is a ton of competition for RNs. We know that. It's actually interesting when you look at some of the healthcare reports that we'll send out RNs everyone. I think we are feeling a little relief in the RA world. We will, for the first time, I think, in 30 years, have a bit of a surplus for a very short period of time, and that is not true in all regions. So those of you that look very concerned you should be, because it's not true in your region right Northeast, do not get excited. It is not happening in your area. But globally, we're in a position where the schools have done their job right. We have regenerated this population.

Speaker 1: 22:20

What are not listed here are imaging issues, our pharmacy issues, our tech issues, all the issues we all know that are going on, and so I think that's part of the dialogue that we need to be in and part of what we need to be talking about, just like Bob said, like what are those hot pocket areas that maybe have not historically received the attention they should, that the shortages are about to grow, and how do you really drill into that? And that's where just really understanding your data and that competitive landscape at each individual job level becomes important. Can you change your requirements for your pharmacy techs, like, let's do some of that work now to make sure that we don't have a bottleneck and a shortage issue in a couple of years? The other thing I just want to show this. So these are actually real systems we work with. I have some real data. Everything in here is real data from our BI platform that we pull together. We pull market information all the time. For some partners it's daily, based on where we're at in the partnership, but at least quarterly we're looking at what is the competitive landscape and a lot of times what I like to do this is teed up for a very specific conversation with a friend of ours in Rochester. But I like to pull markets and I like to pull both comparable markets or markets that you think are thriving, and we try to look at the data and understand what are the similarities, what are the nuances, what are the important factors for you to consider? So I would also encourage you look beyond your own market.

Speaker 1: 23:48

Cincinnati has a very similar demographic profile to Jacksonville, florida Slightly different overall population size, but the demographic mix and the competition for healthcare is very similar. So one of our partners based in Cincinnati. That's the first thing we did. It's how we knew to scope the deal. We had been working in Jacksonville for Baptist Health System for a decade. I knew those numbers like the back of my hand. I was able to instantly connect. This is what we need to consider there and as a result, we decided you know, we've been in that partnership for four years and we're hiring over 6,000 people a year when before they could barely break 3,000. And so knowing your data, but finding relative markets and then creating a relationship with someone on that market, I think all of that is something we can work on now in this little bit of a period of breathing time that we feel that we have Knowing your numbers. So there's a lot of data here and we're not going to review all this specifically, but I actually have homework for you all that I would encourage you to do.

Speaker 1: 24:49

If you can't sit down and fill out your grid, I'll call it on your critical KPIs for your recruitment function. Maybe not you, maybe your director or TA, right? If you can't do that very quickly, we're not tracking the right things, and the reason I say that is these KPIs and these efficiency metrics inform us as to where we're losing people. Where's the bleed? How do we stop the bleed? You can do it unit by unit, manager by manager. You have all this amazing data in your system, readily available to you. If you haven't already invested in Power BI, that's how we call all our data together now. But the workday and the systems are great. The reporting is cumbersome, so if there's some way to put some analytics on top of it for it to do the hard work for you. But knowing your numbers instantly tells you what is off right, what has changed, what has become a negative and how am I going to go laser focused to solve that very specific problem.

Speaker 1: 25:49

This is a subset of a lot of the information that we look at whether it's time to fill or efficiencies. We take this back and look at the stages, the recruitment process. If you don't have your time and stage activated workday, please go activate it. It tells you how long a candidate sat in each stage. We then triage that and that really starts to put together your full playbook for you. This is now my priority. To go, software it's black and white, right, defining your needs. So this is one of my favorite things that we cracked the nut on a few years ago.

Speaker 1: 26:21

We're constantly in discussions around talking with health systems that really did not know how to calculate what their annual hiring needs were, and we were being asked can you please scope out this major deal? Oh, by the way, put a cost per hire backstop in it. Tell us exactly how many people you're going to hire. But our partners couldn't figure that out either. They would know vacancy FTE count. So we started doing this.

Speaker 1: 26:46

We came up with a very, very, very simple formula that I will tell you is very accurate. We use this in every engagement for pricing a deal, starting a deal, and it's part of our annual forecasting partnership reviews, and it's this simple Take the year what's your average time to fill? That's how many times a year your job's going to turn. So that's how many times you can expect that same job opening to reproduce. You take your number of job openings that's active at that time, times the turn that's how many hires we're going to make. Okay, the way that you can make sure that that number is accurate is then measure it against your turnover number. It should jive, and the only time that we see that not be accurate is if your time to fill is so long that we actually need to calculate over a 14-month period of time instead of a 12-month period of time, just to account for that. Happy to do some of this with you, but it's fun, just play around with it, and I think you'd be interested to see how accurate it is for the larger picture when you get granular per unit. There's a lot of nuances there, especially if we have ratio changes happening new towers, all the things that we work through but it's a really great place to start to know.

Speaker 1: 28:04

Next year, I have to hire 2,000 people, right. And then the last thing, and this is the last thing I'll talk on before we open up for questions Again it's really difficult to innovate and be put in that position next to your peer that gets all the funding and all the attention not innovation, patient safety without truly having the right foundation first, and so an easy exercise to go through. This is a very watered down version of it. We actually have a whole assessment you can take on our website. You can entertain and do this as well. Where are you in the life cycle?

Speaker 1: 28:40

You know, the idea is we all want to be in an integrated, evidence-based position Fancy words for saying. You have a very strong optimized process that should be fully tech-enabled at this point, if not have the majority of it fully automated. That is producing a top, world-class candidate and hiring manager experience and has alleviated the pressure on your function. So all you're having to talk about is workforce planning and retention and not about how to get people in the door because you've solved that problem. I would do the assessment if you'd like, but also you can just look through these and where am I at? And then what I like to do is okay, if your vision in five years is to have a one-click process that is fully automated, but you're here.

Speaker 1: 29:34

What are the basic blocking and tackling we have to do first? That's your one-year plan. Your two-year plan is to get here. Your three-year plan is to accomplish. You know probably what has been put on your plate today to accomplish from an innovation perspective. Hopefully this was helpful. Again, this is how we actually operate. It's what we do. This is how we partner with leaders all over the country to sit down at the table with you and help you figure out a place to start. I'm sure a lot of you already do a version of this work today, and it's not overly exciting, right, it's just doing the hard work and figuring out how to operationalize our HR functions in a way that I just don't think we've prioritized historically.

Speaker 3: 30:15

I loved your description of partnership. I love the idea of dual culpability, where you have a client and you have a strategic partner that both have strategically aligned goals and objectives. My question is have you ever engaged in a performance-based risk-sharing contract with a client where the focus is on quality based on time, to productivity and then retention? And then my second question is you noted that Cincinnati is a very competitive market? That's certainly an understatement. How do you protect against conflict of interest when you already have a presence in Cincinnati and you happen to be based in Cincinnati?

Speaker 1: 30:56

Yeah. So the first thing we address the contract structure. So it is very normal now for us to have shared skin in the game. So the way that we're going to work best is in looking at this as a long-time partnership. Right, it takes a while to transform these things. Your average most time, the average time to fill we're walking into a loan, requires for a pretty substantial partnership. But what we have evolved to is we put higher backstops in place. So what is the hires that we're going to think we're going to achieve? We put a target cost per hires. There's already sort of a reimbursement built in if we don't hit that threshold. We also will layer in SLAs that align with your strategic priorities. So whether it's a quality initiative, a time to fill initiative, whatever it might be, we mutually agree on those SLAs as well. And on the front end we try to set what those targets are, but we leave it in many cases for at three months. We sort of regroup on the SLAs we signed, really solidify that the data and the targets are appropriate and then work from there. The CFOs tend to really like this plan because there's dollars, you know. Again, there's shared risk. I will say I haven't paid anything back yet.

Speaker 1: 32:14

So we really work hard with our partners to get the numbers right. Right it has to be fair for both sides. We put in accountability metrics to hold each other. A lot of it is on hiring manager, a lot of it turns to process, and so that's where a lot of fun good process work comes in and not works well and very competitive markets. So the way that we sort of look at it is what is the candidate availability? We do an assessment Are we really really fighting for the same candidate? So we look at everything from commuter patterns, depth of where candidates live versus depth of where candidates work. Are they actually driving left over this bridge or right over this bridge?

Speaker 1: 33:00

We just work in DC a lot with a partner of ours. There's one bridge no one wants to go over, so we start there and then we really talk about is it the right thing for the prior partner that we have? We turn down work. Derek's not like that, but my job is to make sure we can recruit and deliver for the partners we already have, and we do turn down work because it's not the right thing to do. In most cases we can find a place to play together. Maybe it's not everything, maybe it's not nursing. It is very rare that we actually have an issue where we can't figure out a solution to support both parties in a fair way From a delivery perspective.

Speaker 1: 33:45

The way that I manage that is the same. The teams are not shared. Our recruiters are always 100% dedicated to one specific partner and hopefully a specific unit, but a specific area. So you're never sharing recruiters and we structure the leadership to where the leadership is. I'm really your commons nominator right that, and maybe an SVP that ensures that hopefully our best practices are being shared. But it truly is. There's not one winning versus another because of whatever incentive that VP might have that day. But yeah, it's a little tricky. It is tricky especially in the Cincinnati's. Bob Q saw me when Chicago was like stop turning on business, take it all. You know, because we're very protective of that partnership and I'll call my existing partners and say this is the circumstance, can I get your reaction? And nine out of ten times they're going to tell us to pursue it. If they don't, we figure out what the alternative is.

Speaker 2: 34:45

The thing with that is, from my perspective, when you partner with human you sort of own the database. So the people that apply to your organization they don't fish out of that, for you know Loyola or Surrey right, so they. Now what gets tricky is when candidates apply to every hospital in Chicago. So they become in every database and so the choice is theirs of where to go. And so that puts the onus really on the organization for their value proposition and differentiating themselves to say I want University of Chicago Medicine absolutely hands down over Northwestern or Loyola or anybody else. So that's where you know, that's sort of how I view it. With respect to the performance, we never had a performance sort of contract. Now for me that's like having a prenup of some kind. It just doesn't really feel right. When you have the trust, when you have the strong partnership, you know you're not feeling you're taking, you're being, you know taken advantage of. And and particularly you mentioned the word retention. You know that's sort of a you know a thing with me, because a lot of people will say you know, when you hired them, did your retention, you know, get better? And so I view that a little differently. When I hired them, the expectations I had of human was to bring to our doorstep candidates that subscribe to our value proposition, for them to be able to articulate who we are, what we do, what we value, what's it like to work for us. That's as much as I can expect them to do, besides, of course, being followed by candidates Once they cross the threshold into our organization.

Speaker 2: 36:45

The retention is a leadership challenge, a leadership responsibility. They don't have control over it. When I first started, we used to do HR orientation and people who ran the orientation said by the time they left orientation they were all jacked up and as soon as they got to the unit they went fresh and burnt. So you know they control what they can control. If they're bringing us people that aren't a good fit, that's a different issue, but that's what I looked for when they hired people. Are they missing the boat entirely or are they bringing people that we can really mold and groom and you know, make part of our organization long term? You know, make part of our organization long term.

Speaker 2: 37:32

The whole retention thing is just. You know everyone's looking for, you know where to point the finger on that and you know the reality is retention is impacted by the little things that people experience every day they come to work. It's not, you know, we just acquired a new hospital and all that. It's the interaction you and I have in the hallway or don't have. It's the meeting how I was treated at the meeting just an hour ago. It's all these little things that cumulatively make up why I want to stay or leave the organization.

Speaker 2: 38:06

And the thing that always, for years, just puzzled me was, you know, figuring out what drives engagement is a pretty simple thing, because all you have to do is ask yourself what kind of relationship do you want with your employer? Because we all want the same thing. It's not a mystery, right? We want to be paid competitively, we want to be developed, we want to be invested in, we want to be respected, we want to be included, we want to be valued All these things everybody wants. So if you want it, and I want it, why not do that for the people that you're charged with leading?

Speaker 2: 38:46

And when you do that, I think you know who wants to go to work and have a lousy relationship with their boss, who wants to dread getting up in the morning? No way. So work on those things. But it's you know, it's something that perpetuates organizations, because I think we promote people into jobs who are really strong clinicians and now they have responsibility for people and they don't know necessarily how to balance that. And then you add on top of it some of you were talking about the span of control that some of the people have in health care. I'd never seen that in other organizations. It's impossible to have an impact on 150 people.

Speaker 1: 39:30

It's impossible to have an impact on 150 people. The other thing, I'll say just a slightly more specific sample. We understand it's a real thing. So one of the things we try to do is, if we can really refine our forecasting numbers and we can know that you're going to have a lot of new grads that are going to be required to fill up this specific area can we look at investing in additional preceptors? What other training can be put in place to take that responsibility off the managers? And so that's some ways that we'll partner as well as we're thinking about the hiring forecast.

Speaker 1: 40:04

What are the incremental changes that need to happen to support and insulate that manager? Because that's really why the experience falls apart most cases. So again, maybe, as you're thinking about your forecasting and numbers, it's not just up that higher. If you're bringing 50 people into a unit in a short period of time, the unit is help. How can we layer in some additional support? You know, bob, there's more for you. But, sarah, if we're to weigh in, can you talk a little bit about what success or what learnings you have from like the change management of implementing human?

Speaker 4: 40:41

specifically with your hiring managers, who may or may not like that control that they have over the selection process.

Speaker 2: 40:50

So the change most of the musicians that we experienced was going to HR, because over time I think people actually saw the writing on the wall that we were going to be and not everybody does that that works with RPOs or Owerk Newman we were going to change them out. It wasn't. It didn't make sense to me to duplicate, to have an internal team, an external team, particularly because one of the goals that we had was to have a consistent candidate experience. We didn't want, you know, one group of people talking about the value proposition one way and another. So that was important over time.

Speaker 2: 41:32

So the resistance most of it came from the HR team, keep in mind our current process was about as bad as it could get. So you know, when you bring a stack of resumes it's a daunting experience for a hiring manager and we had half hiring managers saying, oh, you mean, I don't have to find my old people anymore. So we went from that to being presented well-qualified, diverse slate of candidates and then the human folks built a relationship with the hiring managers and for me, again, the hiring managers were really the key measurement that I would focus on. If I heard noise at any time, I'd get all over it because I knew that that was going to make or break this whole journey that we're on. But there really wasn't any resistance from the hiring managers and when you think about it, you know they were getting their needs fulfilled with people that you know. The decisions they had to make across this slate of candidates was a hard decision for them. It was, you know, good and better and best that they were being presented with good and better and best that they were being presented with. And so there wasn't pushback from the executives. They were all watching very carefully, there's no doubt about it but they weren't lining up in my office saying what in God's name are you doing? They were like holy mackerel we're getting people.

Speaker 2: 43:10

Our personal best at one time, I think, was hiring RNs in 33 days.

Speaker 2: 43:15

I mean, it was like crazy. So it was all you know, this wave of positiveness that took place and, like I said, the hiring managers became very attached to their recruiters and the human folks knew our organization so well. You know, I remember being picked up at the airport one day from the person who still leads the team today and she's in the car with me talking on the way to the office and she's mentioning all these people who work there, these physicians, these clinicians, this person, that person, and I was blown away by how well she knew not only the people who they work, but their nuances and you know the different things about the personal things about people. So they really make an effort to understand, you know, with the organization and people and the culture. So really, honest to God, it wasn't, you know, we would have lasted nine years or eight years and I certainly wouldn't have been there. You know they would have gotten me a long time ago if things didn't really work out well.

Speaker 1: 44:28

Yeah, what I'll say is, most of the time our biggest challenge is with the talent acquisition team that we might feel they might feel threatened by us, even if it's very clear in the forefront that we're dividing responsibility or it's natural right the hiring manager process. So we do have a dedicated approach and we start off every single relationship with we call it an intake call. That's just part of our natural process. When a new job opening is posted, but the very start of a partnership, or if there's a new unit being assigned to us or a new hiring manager, it is a one-on-one call where the recruiter and the recruitment manager are getting to know you instantly. We ask the hiring manager what your culture is like, what's your preference like, et cetera. So on the forefront there's sort of an alignment that stays true through the duration of partnership. The only time that we see where we have an opportunity to work through challenges with hiring managers is if there's a change in the process that puts a new timeline responsibility on them. So if you come to us and you need to exponentially increase your throughput of hires meaning we have to reduce your time to fill and we all stack hands that the biggest delay is that it's taking your hiring managers two weeks to get back and we put a target in there of 72 hours. We're going to hold you accountable to that. That is usually the only time that we have a little bit of work to do with the hiring managers, but then all of a sudden their needs are being fulfilled and how we work through that is, with the unit leadership, we really make sure the hiring manager has the support that they need to achieve those numbers and that they understand this is a company initiative. We're not picking on you et cetera, what the impact is. But beyond that, hiring managers are usually our biggest cheerleaders and advocates because we're taking so much of the responsibility off of their, their plate and the stress that they feel. So so are there any concerns with your team not being? I'm saying, in your case, pop it recruited, the inch caught it? Yeah, you know, do you have any push that could we get? This asked 100 of the time and 100 percent of the time we are still 100 remote and hire what we need to. So it's been interesting post-pandemic because all of a sudden that tolerance level just changed in general because a lot of your HR teams are now remote, but it comes up a lot.

Speaker 1: 46:56

What we try to do is we go on site on a regular basis. All of our recruiters will go through your onboarding class as our intention. We will walk your unit floors. We end up having face time with hiring managers that maybe prior teams didn't go about it that way, because it's sort of natural that they understood the hospital et cetera. We really do a lot of work in your market to understand it. If there are nuances beyond cover, we try to then get there Like the weird bridge situations that's like a reality in a lot of markets. But yeah, it's always something that's a concern at the forefront and we really just work with you guys to partner understand your EVP. You will work with us to put together an elevator pitch, right.

Speaker 1: 47:39

So each of our recruiters will have their sales pitch to the candidate. It should 100% mimic your brand. No one knows we exist. Our phone numbers are your phone numbers. We map all this stuff so it's seamless. You do not know human exists, the candidate. We don't hide it. If we are point blank ass, that would be lying. But the candidate just doesn't know. They do not.

Speaker 2: 48:05

There are opportunities for them to come to Chicago. There are many opportunities where we have business review meetings and they have some of the recruiters tag along and then they take advantage of that time to personally be their hiring managers.

Speaker 1: 48:20

Yeah, and have job fairs. We still do on-site job fairs.

Speaker 2: 48:23

Just so we're out there. It's always the summer months in Ice Monster.

Speaker 1: 48:29

Yeah, but you know, we sort of assess, like I have one partner that had an on-site team. She wanted two people on site to do a very specific rotation of a group that was really challenging. A new community household they acquired. We put two people on site there two days a week. That's not. It's not gonna last forever, right, it doesn't. They're not gonna have that need forever. But let's figure out what we're solving for and that's how we try to go about it.

Speaker 2: 48:54

We spent a lot of time coming down to Florida. We'd send groups of individuals down here to train them on our benefit programs, our compensation programs, our union contracts, so all those things that they needed to do to be well-equipped about our organization, because they did everything from source to make the offer. And so you know it was to our advantage to invest that kind of time and we would do that regularly because you know the benefits would change and the contracts would change.

Speaker 1: 49:28

Yeah, it gets to. The idea would be just like we have a seamless candidate hiring manager experience, it should also be a seamless experience for you all. So the best partnerships are where we truly are just treated like one of your employees. We're joining team meetings, we're part of that, we're hearing what's going on. Ultimately, we have the right.

Speaker 1: 49:46

The director of comp is part of our contact. You know it's the same, it should not be any different. Of comp is part of our contact. You know it's the same, it should not be any different. Um, really, the difference just comes in and uh, the hopefully, the data. We're going to show you how we will always bring best practices, be able to access a ton of information and insights, and that's my job is to make sure, like we're helping to make you as best in class as you can be. But beyond that, and hopefully, all the levels of service are improving. But if we're bringing a higher level of service, your internal team is going to start bringing a higher level of service. It's how it happens, it's how it works right, and so, the more that we can think about a seamless employment experience and TA experience, all of that translates into all of the work that your candidates feel too, so it's even true of your full interim team today. Yeah, any other questions? Yeah.

Speaker 4: 50:40

We typically deal with three different headways some with how we are positioned in the state, some with the type of work we do and some with the geographical settings on it, so especially the most restrictive settings, whether it is a qualified residential treatment facility, psychiatric treatment facility or psych hospitals. The first headwind that we see from the state is both Kansas and Missouri. The net loser of of not to tell you know compact is great for many other states, but to these two Midwest states ultimately there's a net loss. So that's first thing. Second, the maturity curve of our nurses. We attract a lot of young graduates but by year three they come to us genuinely either through exit survey or concern to us that I'm losing a lot of my skills being in this QRTP, being in this PRT, being in this psych hospital. So we are somewhat kind of collaborating with other hospitals nearby where we ask them hey, are there some parents that our staff can do? So there is some collaboration to go in that way.

Speaker 4: 51:59

So that's the second advent for us. The third advent is some of our hospitals or the psychiatric locations. They are very deep rural regions, very deep rural regions. It works for the nurses who are young, with many under fifth grade kids. But as the kids are getting to middle school and high school they tend to prefer more other local care. So the lifespan of a nurse in our facilities tend to be between that three to five years. So how do you navigate it a bit so yeah.

Speaker 1: 52:38

So your circumstances are real, right, and I would not like to be in your shoes to solve all of those. Right, and I think this goes into being realistic. Then, with what your recruitment and hiring model looks like and what does best in class look like for you is just not going to be the same that it is going to be in a setting like UChicago, medicine or other areas, right? So I think having a realistic understanding of what are we trying to solve for if these factors are real and unperventable, right, and I'm not. I don't know if they're unperventable or not, but they're your reality and one of the things you just said, I saw this done during the pandemic a couple of times and it just wowed me the more that we can start stop thinking about our staffing crisis as within these four walls and you start breaking down the walls of your hospital and start thinking about it and servicing your community in whole and creating partnerships with other groups. And if you can get into the dialogue of how are we going to transfer, how are we going to support this, what opportunity is? Because I think that the big need for your group is the visibility into what's next for them, right? So if you know they're going to have a five-year shelf life because of the reality, so it's going to be really hard to even get them in the front door because they're already thinking about the teenage years. Is there a partnership or a plan that you have that's like we're going to get you ready to catapult you to that next opportunity In exchange for that? This is what your day-to-day looks like right now, et cetera. But how do you take those problems and turn it into the value proposition you're going to offer them? So, listen, I'll just say knowing your reality and sometimes realizing you can't change your reality, that's okay. Now that would help us back into what are the real things you can solve. How does that translate into your volumes and how is that okay for your business and how do we get your investors and board to understand that it's okay for your business? So I think that you've started. You know your limitations. That's a good place to start. So how do we take what we're working with and make it the best experience we can while we're there and then create a long-term solution that you know is out of the four walls? But how, then, do you get someone else pushing those candidates back to you and that reciprocal approach. I think you're going to depend on a lot of network relationships to make that happen. It sounds like you already started.

Speaker 1: 55:19

Listen, we support health systems. At one point it was all 50 states, but it's coast to coast. Every geographic setting you can imagine, every demographic setting you can imagine, you think you have a unique issue. We've heard it and everyone's issues are real. But that's the point.

Speaker 1: 55:39

This treating talent acquisition like an industry-wide solution and a one-side-fits-all solution is not going to work. This is not how we're gonna figure this out. We're gonna figure this out location by location, community by community, and really starting from the ground up and understanding those nuances. And so that's why we're looking at market data and comparison. Don't just pull up the big backers report that's commuting in the northeast right. Let's take it a step forward. Let's look at similar demographics, look at similar markets and partner with people that are in your role in that area, so that you can understand what they're doing and hire you to work. Even if you're thousands of miles apart, you have the same exact issue. If you're in this specific demographic, this specific market and find those like people, really, really drill down, and that's a big part of our secret to our success is taking our data and taking our experience as very finite examples and realizing how they apply to the circumstances that we're facing and being again realistic with what is possible.

Speaker 1: 56:45

You know, does that help? Yes, all right, I think we are at lunch, but we're around, so if you have any questions, I'd like to talk to you. Appreciate your time. If you haven't done the QR code, I'll put that back up. But also we have your information, so if you go here, you'll get to a landing page. It's a 2025 state of health care report. You can navigate out of that. Our resource hub has the talent maturity model. It has ROI calculators. There's more resources than we possibly know what to do with. I'm even being filmed today. I will become a resource at some point, but spend time there. It's all this information you can download. It's all yours. Hopefully it helps on your TA journey. So great Thanks.