Our next faculty member will build on the granularity of team culture cultivation. So it's my pleasure to introduce and welcome Debbie Sahls. Debbie is Director of Nursing with Ohio Gas Neurology Group and Central Ohio endoscopy centers, based in Columbus, Ohio, which is a 38 physicians single specialty gas neurology group with five endoscopic surgery centers. Debbie, the audience is yours. Thank you, Dr. Eisenberg, and I want to thank Eden, and all the ASG staff for inviting me to participate and present in this very informative program today. So, let me take control of this here. Okay, there's my disclosure slide. Today I would like to talk about the process for optimizing personnel recruitment and training. I want to review a list of key elements and successful employee recruitment and training. I'd like to identify warning signs that you may have when you interview those applicants that could lead to you having challenges later on with those employees, and then describe best practice for addressing when we end up with an employee that may be disruptive. So optimizing recruitment and training. You want to make sure that you have effective staff, and that starts at the beginning of the recruiting process. You just don't want a warm body selection process. You know, your optimal staff would tell you that it's best to work short than to have to deal with someone who may be difficult or be a bad apple. When you're interviewing, take those references, you know, try to reach out and ask for more if you if you have some questions about their ability to fill the role that you need them to do. Look at their resume, look for warning signs. Maybe they've been a job hopper, maybe they've had excessive salary demands, and they're immediately asking you to bump up the rate that you're offering, or, you know, the position that you're looking for. So key elements in recruitment. You want to determine who you want to recruit. Is this somebody who's going to be line staff, your worker bee? Are they a specialist? We have informal and we have formal leaders in our practice in Ohio. You want to ensure that that role matches up with what the recruit is expecting. You want to make sure that your HR person that is helping you recruit, or maybe if you have a recruiter, that they understand that role. So when they set up the interviews and do those screening questions, they are able to answer some of the questions that the recruit might have. They want to know what you're looking for. So if they're going to be a tech and their job is specifically scrubbing scopes all day, you want to make sure they understand that right off the bat. You don't want them to get hired on and then have a surprise in what they're supposed to be doing once they get there. As I mentioned earlier, you want to be forthright. Is it day shift? You know, are there going to be late days? Are they going to get called in on a day off? Can they get out early if they ask? You don't want to convince somebody that they're going to get a 7 to 3, 30 position. If you are sure that most days your doctor may run late or the patients may come late, or there's an issue that everybody's expected to stay until everything is done, that sells a bad product for them. So be honest in the interview. Let them know that they may have to travel. I know in our centers, the expectation is that they have to travel to any location if the need arises. So you want to make sure that they're aware of that. And how does that process work? Do you reimburse? Do you offer gas cards, which is what we've done through the holidays to kind of ease that level of cost for gas that we've all suffered through? Is there cross-training and being there again until the work is all done and so that everybody gets out in a timely fashion? You want to identify those warning signs from the applicants that could lead to the challenges later on. Listen to them. As I said, asking for extra days off before you've even hired them. Have them job shadow with your team. A lot of times when they job shadow, we have them interview and job shadow same day. They come in, they work with our staff, watch our staff, ask questions. It allows the staff to be able to get an idea of how they would mix with the group that they're working with. So large practices, ours in particular, we actually have a recruiter that we hired. It works with our HR team. So we give her our job request and what we want. And she actually puts it out there, recruits off of LinkedIn or Indeed or whatever sites that you may want to use. And then she screens those people for specific job descriptions that we need. And then she sends on those resumes to the managers and they look at those and say, yes or no, I'll interview this person. So that saves you a lot of time. A smaller practice might want to consider outsourcing that. It gives them the ability to select candidates that are best for your needs. It'll reduce some overhead and time investment internally. And it assists in developing the key attributes. Sometimes they could be more objective if they're an outside company as well. So you don't want to have somebody start in your training and just have the old see one, do one, teach one. We're all guilty of that. I know that sometimes staffing shortages has us pull our new orientees and have those nurses working just in the recovery area just because we need a person to cover that. Try to avoid those situations. Base your training around building their skills. So if they're starting in the pre and post area of your recovery area, say for instance your nurses, and that's the base that they need to know about. They can hear all the prepping and scheduling. And so they really understand how your center flows. And then build on those skills. Move them into the next area of training once they're ready. You can develop a skills checkoff list, competency forums. You can utilize your staff to help you put that together. Don't reinvent the wheel. You can develop it in-house if you want. There's a lot of groups out there who would like to network possibly. And they can share the way they've done things in the past. The main thing, too, is you don't want to waste time training on items that they're maybe not going to do right away. Maybe the goal is in a year from now that they work in the procedure rooms. Well, if they're going to go in and train and then leave that area, it's not going to do you any good or them if they're not doing that for six or eight months. So organize your training based on where you're expecting to place those employees. So in elements of training and retention, again, as Dr. Martin had mentioned, engage your staff. You can make them informal leaders. They can develop training and competency processes for you. They know how it works. They're in those areas every day. They're following those standards. They know what works best. We've tried to do it this way. This is a better way to do this. So engage those people and utilize their expertise in their areas. This will build confidence for them. It will drive others to be more knowledgeable because they're wanting to be thought of as a leader or somebody that they could be used to mentor. So you can use this as a clinical ladder. We've placed tech leads in our centers. So that way we've watched those most valuable techs who really do a good job and pay extra close attention and want to train new techs that come in. We've made them leads. So you can offer them more money, incentivize them. We also offer a certification program. If they go through a course and get certified in scope reprocessing, we increase their pay a little bit and they become those experts in that area. So it adds a lot to their confidence and knowledge. If at all possible, don't rush the process. Again, I say that knowing that we do that often because staffing shortages and such. But if at all possible, just make sure that they get the time they need to learn. Be specific on what you're going to evaluate them on and set those goals. Meet with them frequently. Let them know how they're doing and set further goals or turn them to the person that might be able to help them in the areas that maybe they have some challenges with. So unfortunately, we all have had those disruptive employees. So when you have an employee that is disruptive, that's any conduct that interferes with the effective operation of your unit, or it's just a threat to personnel or to a patient, they are considered disruptive. That person's behavior is unusual, unorthodox, is different, or not alone sufficient to classify as disruptive behavior. The best way to handle disruptive employees, hopefully not to hire them, right? So again, pay attention in those interviews, you know, take those referrals, you know, talk to those people that want to give a reference. Don't take people from other departments because that person needs a break. Oh, and maybe if they just changed atmospheres, they do better. I think you're just taking on somebody else's problems. You're not going to be able to fix them. They're on their best behavior in an interview. So sometimes you get those people automatically after an interview or maybe the shadow and you think they're a great person. And then all of a sudden these red flags, you know, pop up once you get them. So pay attention, trust your gut. If they're not working out, you got to cut them early. The important thing is to make sure that your staff feels supported with other good employees and that you're listening to their concerns. So when you address this disruptive employee, they can sometimes be challenging. They act out, right? They just, they're constantly tardy to work, no matter how many times maybe you've talked to them or given them a record of conversation or even a counseling with a, you know, a verbal or written, you know, sorry, that, you know, something that you've given them as a counseling, either written or warning or a verbal warning. They may refuse to complete tasks or they're just trying to be lazy about it. You know, well, it's not my room. I'm not supposed to stock that room. That's, you know, I didn't work in there today. You know, we all need to be a team together, right? So the one thing you don't want to do is to have this disruptive employee escalate to a threatening behavior. So you want to make sure that you have prompt and consistent intervention from your leadership. Somebody that's disruptive can quickly become dangerous, right? We don't want to put anybody else in harm themselves or patients or any other employees. So if you have someone who's beginning to show some dangerous behavior, you need to have an immediate intervention. Our company, we have a zero tolerance. You want to spell that out in your policies and procedures. Discuss that, you know, at the time of hire. You know, termination for the safety of well, the well-being of patients and staff is, you know, necessary. You want to make sure that anybody who notices disruptive behavior that's dangerous or causing problems, you got witness documents. The more document that you can get, the better you are, you know, should there be any kind of, you know, follow up legally or maybe from, you know, having them say that we didn't treat them fairly. Have a second person with you. So I always tell my managers, if there's somebody that they need to ask to leave due to being disruptive or dangerous, you need to have somebody else with them. So they have a supervisor or charge nurse, at least with those managers. So you have a witness as to what happened and why they were escorted out. So best practices addressing the disruptive employee. We want to define disruptive and dangerous in your policy and procedure so that the employee understands and signs off that, you know, most employers will have you sign that you received the office policies and procedure manual. This is important during onboarding and you want to make sure on annual competencies that your staff is reviewing the policies and procedures because those do change for different reasons throughout the year. So it's always important to make sure that they have documented that they understand policy. Reinforce the administration's lack of tolerance for disruptive or dangerous behavior. Again, during that onboarding process, you let them know what you expect, what is unacceptable. You know, we really need you to be here on time. You know, we really need you to stay till everyone finishes. Everybody's part of the team. We can't just say it's your room or my room. Explain how the counseling process works. Let them know that, you know, we're going to start with a record of conversation just to make sure that you understand what is expected again. And then you move on to those counseling or written or verbal warnings as they progress. After the counseling, you want to be specific. You want to write a performance improvement plan. So we call that a PIP. You want to discuss the PIP with the employee. You want to schedule firm dates. This is our date for follow-up and you want to give them meaningful feedback. They need to know what they're improving on, how they've improved, or maybe they're not quite understanding what was required. Review that with them. Make sure that they, again, have that person that's going to be best to be that role model for them to show them the way that they need to be. Have in writing the consequences of failing to meet the improvement objectives. You have to include up to and including immediate termination. We have that on all of our counseling forms. That is definitely in our policy and procedure manual under our expected, sorry, performances. And important for the leader, you have to document, document, document. Every time you have this conversation, every time that you sit down with this employee, you want to make sure that you're kind of building that case, if you will, that should that need arise for termination, that you have the dates and times that you talked and also have those warnings or counselings signed, if at all possible. So, in summary, when you're recruiting, you want to be specific and selective about who you're looking for. You know, don't waste time and effort and resources just filling it with anyone. You want to make sure that that interview is meaningful. Spend your time talking to them and listening to them for red flags, if there are any. Have them job shadow so your staff can interact with them and provide their opinion on how things went during that interview. Keep the staff trained. You want to make sure you invest in your staff that you keep. Offer incentive pay. We do an incentive pay for precepting a new employee. So, the employees that, you know, constantly are having to orient new staff, you know, sometimes they're like, yeah, I don't want to orient another person. Offer some incentive pay for them. You know, give them that title as a preceptor. Everybody likes to know that they're valued. It is expensive, as Dr. Martin mentioned, to recruit and train staff. So, when you lose somebody and they don't feel valued and you lose that person, you start back at square one. That's a lot of money lost. But, on the other hand, you need to know when to cut them loose. So, you can remediate with employees, but don't overinvest. If you've done your due diligence, you've talked with them, you've gave them the tools that they can use in order to succeed, you need to know when it's time to just cut your loss. Thank you very much.

personnel recruitment

training

effective staff

job shadowing

disruptive employees