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“Gone With The Wind: How To Retain Our APPs”

“Gone With The Wind: How To Retain Our APPs”. Nicola Hawkinson DNP, RNFA, RN CEO & Founder of SpineSearch AASA May 9, 2016. Disclosure SpineSearch, LLC Founder, CEO. Mid Year Retreat. Hospitals and healthcare provider adding 374,000 new jobs in 2016

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“Gone With The Wind: How To Retain Our APPs”

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  1. “Gone With The Wind: How To Retain Our APPs” Nicola Hawkinson DNP, RNFA, RN CEO & Founder of SpineSearch AASA May 9, 2016

  2. Disclosure SpineSearch, LLC Founder, CEO

  3. Mid Year Retreat • Hospitals and healthcare provider adding 374,000 new jobs in 2016 • Healthcare unemployment rate is at a mere 2.6%; its lowest level in 9 years! • This trend continued into the first half of 2017 with 50% more hires than the first half of 2016

  4. Mid Year Retreat • 10 Year Forecast • PA – projected growth 38% • NP – projected growth 35% • The Bureau of Labor Statistics

  5. These Trends Do Not Come Without Controversy • New York Times Articles • Oct 1, 2001, “When The Nurse Wants to Be Called Doctor • April 29, 2014, “Nurse’s Are Not Doctor’s” • August 1, 2014, “The Physician Assistant Will See You Now” • May 25, 2015, “Doctoring Without The Doctor” • Title • Report to • Scope of practice • Responsibilities • Hours

  6. Why Such Growth • People living longer • Technology has driven greater specialization • More tests to give, more meds to prescribe & more devises to utilize • Physician’s need for more help

  7. Forbes • “Advanced Practice Provider’s Are Key To America’s Healthcare Future” • Congress debate to repeal and replace the affordable care act – APP’s at the forefront of this discussion • Increase pressure to reduce cost • Decrease readmission • Decrease length of stay • Increase access to care *21 States now offering full practice authority to NPs*

  8. Recruitment Trends • The GAP • Hiring Challenges • Innovation in recruitment strategies • Digital Marketing, Social Media • Seeking passive candidates • Evidence-Based Approach To Hiring

  9. Hiring Challenges • Hiring Challenges • Top 5 Obstacles • Finding Qualified Candidates • Finding Quickly • Finding Enough • HR/Recruitment is only part of my job • Location (local candidate supply/relo/rural location)

  10. Evidence Based Recruiting • The Parallel to Evidence Based Medicine • Physicians once too went on hunch –anecdotal evidence and personal experience… • Research – drive decision – treatment guidelines, policies • (See our 7 steps)

  11. Our Conclusion • NP / PA Position In High Demand With Low Supply – GAP • We Must Be Organized and Proactive In Our Recruitment Strategies and Interview Process • We Have To Identify Both Long And Short Term Staffing Goals • Traditional Methodology Will Not Suffice!

  12. How do you find your APP • a. placing ad • b. internal referrals • c. external recruitment firm

  13. Retention • In Order To Retain Employees, We Must First Know Why They Leave….

  14. Turnover Rates • 6 Reason’s People Leave • Feeling Undervalued • Individual Recognition • Too Little Coaching / Feedback • Job Did Not Match Job Description • Mismatch Between Job & New Hire • Management Freezes Raises and Promotions **The Cost – up to 2/3 of their annual salary**

  15. What is your current turnover rate • a. less than 10% • b. between 10-20% • c. greater than 20%

  16. Turnover Rates • Becker’s Hospital Review • Hospitals will need to replace >50% of their staff every 5 years • Attributed to a shrinking talent pool, and retirement • Survey Concluded • Continuity in Hospitals is Lacking • Environment Promotes High Turnover (Burnout) • Growing Proportion of Retiring Employees • Hospital Hiring Needs To Tune Up • (Becker’s, May11, 2017)

  17. What percentage of your APPs have been with your institution greater than 5yrs • a. 0-10% • b. 10-30% • c. 30-50% • d. 50-70% • e. greater than 70%

  18. We Found Them:How Do We Keep Them • Salary (Metrics) • Benchmark Data • Training • Orientation • Mentorship • Benefits • Health, Retirement, Continuing Education • Career Growth • Promotion Guidelines • Strategic Incentives

  19. Case Presentation • University Of Colorado, School of Medicine • Stephanie Farmer, Director of Finance and Administration

  20. How long does it take from application to offer • a. 0-30 days • b. 30-60 days • c. 60-90 days • d. greater than 90 days

  21. Are We Going To Pay • Salary Statistics • Benchmark Data • MGMA • AAOS • NERVES • Surgical vs Non Surgical

  22. How long do your average APP positions stay vacant • a. less than 30 days • b. 30-60 days • c. 60-90 days • d. greater than 90 days

  23. What benchmark data do you currently use to determine APP salaries • a. MGMA • b. AAPA • c. INDEED.COM • d. AANP • e. Other (fill in your answer)

  24. Salary Survery NP PA - 2017 • Job Satisfaction • Signing Bonuses – 11% (11k NP, 8k PA) • Salary Trends – 50% noted salary increase from 2015-2016 • (Practice Match)

  25. Are We Willing To Train • Specialized For APPS • Ongoing • Related to Specialty Field • Leadership traing • Peer Group / Leadership Council involved in process

  26. Benefits • Malpractice • LIC/DEA/NPI • CME Allowance • Vacation • Health Care • Retirement • Education Reimbursement • Bonus (sign on, relocation)

  27. Benefits • Strategic Incentivization • Q6 month retention bonus • Differential for preceptorship • Differential for certifications • Differential for taking on leadership roll

  28. Career Growth • Promotion • Advancement in responsibility (training of RNs, preceptorships, lecture series) • Leadership council opportunities • Research / Publication opportunities

  29. The Golden Goose • # 1 Reason employees stay in a job for extended periods of time is “Work Place Culture” • Easier said than done but creating a dynamic, advanced and unique work place culture is why employees stay

  30. The Golden Goose: Culture • Building A High Retention Culture • Journal Of Nursing Administration • Job Embeddedness: Development of a Nurse Retention Plan • Measure – Personal Characteristics – Job Search Behavior index • FIT – Organization, Community, Job Description • Georgetown University

  31. Culture • Create an environment of growth • Provide sufficient staffing • Create a strong organizational culture • Assign a mentor • NSI Survey, 2014

  32. Conclusion • Recruitment and Retention Go Hand In Hand • Approach Must Be Proactive, not Reactive • Staffing Needs Must Address Both Short And Long Term Goals • We Must Learn How To Incentivize To STAY!

  33. SpineSearch Premier Recruitment For Clinical and Administrative Staff 516.333.5050 www.SpineSearch.com

  34. SpineSearch See You All In San Diego

  35. References Kuncel, Ones, and Klieger, In Hiring, Algorithms Beat Instinct, Harvard Business Review, May 2014 Liker and Hoseus, Toyota Culture, The Heart and Soul of The Toyota Way, Forward, McGraw-Hill, 2008 Marvelle, 2001 AAPA Physician Assistants Consensus report, Running et al, 2002-2003 R.S. Hooker and L.F. McCaig “use of Physician Assistants and Nurse Practitioners in Primary Care”, 1995-1999 New York Times, 2011-2015 Practice Match, 2017 Time Magazine, June 22,2015 Warren, Brian, Select International, An Evidence Based Approach To Hiring

  36. Thank You! Nicola Hawkinson, DNP, RN SpineSearch www.Spine-Search.com 1.516.333.5050

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