Recruiting and retaining staff is a major challenge for rural and remote health services. Organisations must consider individual candidate factors, internal organisational factors and external factors (e.g. adjustment to the community) for effective recruitment and retention. Important factors include a candidate’s rural background and the career development opportunities provided by an organisation, with financial incentives and professional support networks also impacting.
ZED Management Consulting (ZED) recently performed a review of recruitment and onboarding processes (including end user experience) within a rural and remote health service, culminating in a series of recommendations for improvement. The service aimed to be an employer of choice and was keen to ensure that recruitment and onboarding processes were streamlined and that the experience would be supportive for both current and prospective employees.
Our client was a health service with a large number of recruitment actions per year (approximately 5,500) and a highly transient workforce. The majority of employees (60%) had been at the service for less than 5 years, and over a third (35%) were in temporary or casual positions. Approximately 40% of the workforce was nursing staff, 11% was medical (with an annual turnover of around 50%), and 17% were in administration.
The health service identified that recruitment and onboarding practices and processes varied considerably across its service groups and professional streams. There were common and unique challenges faced by the organisation, including:
No strong employer branding strategy and plan for promoting the service to the target groups it wanted to attract, recruit and retain.
Problems recruiting to the region, with a recognized need to develop the local workforce.
A strong burden on already busy senior clinical leaders (e.g. senior nurse managers) to manage recruitment activities.
A lack of competitive salary incentives for medical staff when living and travel costs were accounted for.
Variable approaches across the service for using networking events (including national and international conferences) to attract medical staff.
Uncoordinated advertising processes that were not designed to strengthen the employer branding strategy, with administrative processes also duplicated.
Inflexibility in employment policies and practices which created barriers for engagement and using the workforce to its full capacity.
Inconsistent onboarding processes for new starters, to support new recruits and their families to settle into the remote region.
In order to address these challenges, ZED:
Reviewed current recruitment, selection and onboarding processes in the health service to understand work effort associated with a range of recruitment and onboarding sub-processes across service groups; as well as strengths, challenges and opportunities areas in relation to strategy, governance, people, culture, process, technology and user experience. This review included: development of a data collection tool and data collection across the service to examine current processes; analysis of staff time allocated and workforce data; consultation meetings and workshops with key stakeholders across the service; and a survey on the end user experience that engaged a representative sample of recent applicants.
Reviewed similar health services in Australian jurisdictions, to identify best practice recruitment and onboarding processes and jurisdictional trends.
Developed a report with best practice recruitment and onboarding processes and experiences and recommendations for the health service to improve and enhance their current processes, in alignment with the best practice model.
As part of ZED’s final report, current recruitment and onboarding sub-processes were assessed using a common assessment framework and presented using a common visual dashboard; key issues were identified, and recommendations made across four key areas:
1) Strategy, Structure and Governance (e.g., developing workforce recruitment and attraction strategies, expanding the use of bulk recruitment programs and establishing and expanding talent pools)
2) People, Resourcing and Culture (e.g., investing in dedicated workforce planning resources including business intelligence data and developing internal talent to promote retention)
3) Process and Technology (e.g., investigating system enhancement possibilities such as eRecruit and establishing panels of locum medical officers)
4) Applicant Experience (e.g., utilising new digital hiring platforms and mobile technology to reach prospective candidates and establishing a single point of contact for induction to navigate processes).
The client has recently embarked on the process of developing an action plan to support the implementation of the 16 recommendations provided by ZED.
