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Retention Insights Recruitment and Retention Best Practices.

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1 Retention Insights Recruitment and Retention Best Practices

2 Retention Best Practices Retention in Indian health programs is built upon a series of best practices: Recruitment Leadership Communication Shared Management Professional Development Community Relations

3 Recruitment “If you fail in the recruitment and selection of great people, you won’t have great employees. And without great employees, how can you possibly have a great company?” MICHAEL WRIGHT IDEAL PEOPLE LTD., MANAGING DIRECTOR

4 Recruitment Recruitment ̶ The act or process of supplying organizations with new members or employees. The Value of Recruitment Effective recruiting focuses on strong team players. Effective programs sustain employee motivation from initial recruitment to long-term retention. Effective recruitment of new employees can be rewarding for both employees and the organization.

5 Recruitment Recruitment in Action Building long-term relationships with new hires will reduce your turnover rate, as well as: Create trust. Support and encourage staff. Make your team feel secure and valued.

6 Recruitment Onboarding for the Long Term Focus on retaining good employees before they’re hired. Bring in qualified people who fit with the organization and staff. Discuss the Tribal culture and the Indian health system. Avoid applicants who show a potential lack of interest in a long-term commitment to your site.

7 Recruitment Make the Most of the Orientation A thorough orientation ensures new hires feel comfortable from the start. Use the orientation period solely for initiation/onboarding activities. Provide a glimpse into the activities of every department. Begin with the basics. Ensure the new hire understands and completes all compensation and benefit information accurately.

8 Recruitment Build Your Team in Blocks Use connections to build your team. Ask your staff to recommend acquaintances. Hire a group of people from the same school. -They will have a built-in social network. -They will form a stable nucleus.

9 Recruitment Finding Opportunities for Spouses Explore opportunities with local businesses or private entities. Work with your personnel department to create flexible positions. Encourage other staff members’ spouses to form a welcoming committee/community network for spouses.

10 Leverage Your Location Tout the unique settings where Indian health facilities are located, many of which offer scenic and cultural amenities. Promote the abundant opportunities for outdoor and recreational pursuits. Recruitment

11 Show Your Appreciation Before You Hire A personal pre-hire informational package could be the final selling point. This could include: The Successful Transitions (Urban to Rural) brochure and workbook. Items of interest to the candidate, such as a listing of religious services and places of worship; school boundaries, registration and education program information; utilities, real estate and Tribal/local Area site information. A copy of the local newspaper. Often weekend editions include retail ads, employment ads and housing information.

12 Recruitment Focus on the Mission Describe the unique clinical and cultural opportunities. Talk to candidates about the unique opportunity to serve an appreciative and deserving patient population. Explain the emphasis on providing patient-centered care while working among an interdisciplinary team of clinicians. Explain what to expect from a typical day on the job (hours, patients, tasks, resources).

13 Recruitment Make Time for the New Hire to Meet the CEO CEOs and recruiters work together to turn candidates into new hires — and new hires into valued team members. Schedule half-hour or one-hour meetings with visiting candidates and new hires. Listen to their concerns and answer questions about the job and the facility. Inquire about the factors or influences that attracted them to an IHS career. Share your own story about how you came to the IHS. Inquire about their outside interests and hobbies and what attracted them to your community.

14 “Management is doing things right; Leadership is doing the right things.” PETER F. DRUCKER Leadership

15 Leadership ̶ The ability or function of a leader; the act of providing guidance and direction. The Value of Leadership Strong leaders are able to successfully direct the actions of others toward a goal, whether it’s individual or organizational.

16 Leadership Leadership in Action Employees look to their managers for guidance with: How to view the organization. How to view their place in the organization. How to perform their role.

17 Leadership The Executive Manager Role An Executive Manager should: Know his or her employees’ strengths and challenges in the workplace, but also know them as people to make a personal connection. Identify and remark upon employees’ unique abilities. Provide support and guidance to develop needed skills and perform job duties with success. Be available for questions, concerns and ongoing dialog about career development.

18 Leadership Set the Standard Nurturing your staff can positively affect: Spending. Effective cooperation. Community relations. Demonstrate that every staff member counts. Show your support daily. Create an environment that fosters personal success.

19 Leadership Make the Right Decision There are times when executive management needs to make difficult choices. In order to gain staff acceptance when making tough decisions, you should: Emphasize that patient care is your top priority. Depersonalize the decision-making process by emphasizing your role as the patients’ advocate.

20 Leadership Encourage Longevity, Discourage Turnover High turnover is bad for Indian health programs on multiple levels. Sometimes a disgruntled departing employee can create a temporarily unstable work environment for those around him or her. Vacancies create heavier workloads. It’s difficult to create unity and attain goals in unstable settings.

21 Leadership A stable, effective environment: Attracts individuals who will stay. Perpetuates good work and career habits. To encourage longevity, employ effective leadership: Be available to staff daily. Attract the best by being the best.

22 Leadership Work the Late Shift If your facility is open 24 hours a day, seven days a week or has a night shift: Include those hours in your own work weekly. Extend your day or come in later. Work a weekend regularly.

23 Leadership Let Your Professionals Practice One reason employees leave the Indian health system is that their work environment doesn’t allow them to do their job well. To avoid this: Create a practice setting in which employees can perform to the best of their ability. Help employees by staying actively involved in their professional activities. Protect your staff from interference caused by problems within the system.

24 Leadership Increase Your Exposure Provide opportunities for your staff to interact with you by stepping into the clinical setting twice a day or more. These chance encounters offer opportunities to: Build personal relationships and closer professional relationships. Show staff that their welfare is a priority. Make staff members feel valued. Give staff the chance to bring up questions or concerns.

25 “The single biggest problem in communication Is the illusion that it has taken place.” GEORGE BERNARD SHAW Communication

26 Communication ̶ An imparting or interchange of thoughts, opinions or information. The Value of Communication Communication is an essential component of any relationship and an important skill to master for any manager.

27 Communication Communication in Action Successful organizations communicate effectively. The benefits are: Increased employee commitment. Improved morale. Reduced turnover. Better decision making. Improved workplace relations. Enhanced workplace learning.

28 Communication IHS managers should: Provide encouragement and praise for a job well done. Recognize achievements. Step in when assistance is needed. Give and receive feedback. Respond to ideas and concerns.

29 Communication Be accessible. Instead of waiting for your staff to come to you with problems, be proactive: Deal with problems before they become larger. Improve perceptions. Build relationships. Show your willingness to help employees.

30 Communication Everyone Has an Idea That Can Make a Difference Use your staff’s knowledge to inform your decision making. Establish regular staff meetings. Meet with staff leadership routinely. Keep them informed on any progress made on their behalf or that benefitted from their input.

31 Communication Recognize the “B” Team Often, positive feedback is given to “A” employees, but a pat on the back works for employees at every level. Thank the “B” and “C” players who helped the “A” employees achieve success. Recognize efforts on a personal level. Validate all employee achievements.

32 Communication Good Timing Can Be Crucial How you communicate is often less important than when you communicate. Take care of situations immediately. Follow up on requests in a timely manner. Respond to . If you don’t pursue problems as they occur, you may be incubating a larger problem.

33 Communication Using the Chain of Command Some situations could potentially impact or undermine a supervisor. Understand the supervisor’s position and respond supportively. Use what-if scenarios to prepare or share situations from other departments and ask supervisors what they would have done. Coach your supervisors before issues arise.

34 Communication Get Feedback and Use It Use customer feedback to improve customer satisfaction. Develop a follow-up survey that: Is easy to understand and complete. Offers ample space for comments. Respond personally to the survey, answering any complaints when necessary and post your responses in a location where your patients can see them.

35 Communication More than a Suggestion Box – An Action Box Having the CEO act on suggestions breeds goodwill. Respond with concrete action. Use your authority to get results. Be timely with your response.

36 “Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has.” MARGARET MEAD Shared Management

37 Shared Management ̶ A partnership; a working relationship that depends upon a joint effort. The Value of Shared Management Partnering with others to achieve goals spreads the weight of responsibility, as well as the thrill of success. Building an inclusive environment is an important way to achieve employee buy-in and motivation.

38 Shared Management Shared Management in Action Sharing decision making with employees can dramatically advance an organization. Success depends on total buy-in from the top down. Staff are empowered to take ownership of outcomes. Executive leadership must fully support its team members.

39 Shared Management Give your staff responsibility to lead initiatives: Allow staff to make decisions in an effort to foster ownership. Employees will recognize that management values them as professionals.

40 Shared Management Support From the Top Is Critical The entire executive leadership team must support implementing initiatives. Establish a forum for executives. Gain the support of all clinical and medical staff. Provide accurate information throughout the process.

41 Shared Management Let Others Lead Your professional staff has a voice; take advantage of it. Let them set the agenda, weigh in on decisions that impact their staff and research and propose solutions to challenges. Delegate leadership tasks and responsibilities. Encourage them to share their knowledge in meetings and discussions, as well as with other staff members on the job and to suggest ideas and areas of improvement.

42 Shared Management Give Ownership to Others Everyone has a stake in the success of the organization. Sharing responsibility shares risk. When staff face outcomes, they learn to correct outcomes. Holding staff responsible for outcomes lets them know you trust them.

43 Shared Management Leave Hiring Decisions to Your Staff Make a point of relinquishing the hiring authority to your staff members – you may be surprised and gratified by their choices.

44 Shared Management A Consensus Speaks Volumes Presenting a united front among your leadership team offers several benefits: It sends the message that you are a team. Sharing information and decision making fosters a committed relationship with staff. Communication among executives prevents wasted efforts.

45 “When inspiration does not come to me, I go halfway to meet it.” SIGMUND FREUD Professional Development

46 Professional Development ̶ The act or process of acquiring and developing new skills. The Value of Professional Development Up-to-date skills are necessary in today’s workplace environment. It is vital to give employees opportunities for continued learning.

47 Professional Development Professional Development in Action Continual learning means ensuring that the proper, most current tools are in place. When you invest in your employees, you invest in the community. Being creative with your budget to provide training is crucial to the level of care you can provide.

48 Professional Development Employees are our greatest asset. By providing them opportunities for continued learning throughout their careers, we demonstrate our commitment to them.

49 Professional Development You Have to Spend to Save Can you afford to lose well-trained staff? Probably not. Continuing education is a crucial cost of doing business. Training opportunities enhance staff performance, morale and retention. The cost of replacing professional employees is more than twice their annual salaries, so money spent on training will save many times the amount in turnover costs. Plan your budget to include staff training and stick to it.

50 Professional Development Reap the Benefits of a Well-Trained Staff Set aside a portion of your budget and give your staff a dollar amount that is available for training. Build up a funding cushion and use prior-year monies to eliminate crunches. Staff members need to maintain their licensure and keep up with their professions. No effort is too small.

51 Professional Development Better Practices Result in Better Patient Care A little education goes a long way. The more your employees learn, they better they’ll perform. Better patient care will encourage patients to return.

52 Professional Development Be Innovative If budget limitations restrict training for your staff, find new ways for them to learn. Use university programs as field educational sites. Consider on-site training. Bring trainers in-house.

53 “The glue that holds all relationships together – including the relationship between the leader and the led – is trust, and trust is based on integrity.” BRIAN TRACY Community Relations

54 Community Relations ̶ The relationship between local, state and/or federal entities and the local communities. The Value of Community Relations The spirit with which relationships are maintained affects how organizations work together. Constructive attitudes, optimistic actions and friendly interactions create successful relationships.

55 Community Relations Community Relations in Action Local politics can affect your employees. Proactively initiate regular communication with local leaders. Be transparent and open with local leaders when issues arise. Encourage staff members to ask for help or support from IHS leadership. Staff members should not deal with these issues on their own.

56 Community Relations IHS Community Relations Some Indian health communities may encounter situations that can become confrontational. Solid, friendly relationships with local government entities are vital. Resolving issues can be as simple as developing a relationship of shared understanding.

57 Community Relations “Every Patient Is Important” Patients want to experience concern on the part of their caregivers. Respond to every patient who enters your facility as if he or she is the chief or Tribal chair. If a patient complains that needed treatment is not being supplied, explain the situation to the patient. Always treat patients with respect and concern.

58 Community Relations Be a Buffer Your staff may not have the training/experience necessary to handle Tribal politics. You must be able to act as a buffer between professional staff and local politics. You must be well versed in Tribal politics and have your professional staff deflect political issues to you. Meet regularly with Tribal representatives.

59 Community Relations Work Together To Resolve Issues Maintain open communication with the Tribal government. Let patients know their issues will be addressed. Remain open-minded and stay focused on good patient care.

60 Community Relations Communication is Vital to Council Constituency Tribal council members must be informed in order to respond to their constituency. Support them by providing information. Share information they might not otherwise receive. When you support Council members, you will find they support you.

61 Community Liaisons A good way to ensure communication among your facility’s staff, the local community and Tribal representatives is to to appoint a community liaison. Community liaisons represent the best interests of each party by communicating with each entity effectively, providing positive feedback, identifying any matters of potential concern and encouraging shared interest in conflict resolution. A community liaison can also serve as a mentor to new staff members by introducing them to the community and educating them about Tribal customs, cultural traditions and observances.

62 To raise the physical, mental, social and spiritual health of American Indians and Alaska Natives to the highest level. Mission Statement INDIAN HEALTH SERVICE Onboarding Checklist

63 Prior to the Start Date Welcoming an employee to your Indian health facility and paving the way for long-term success is easy if you set up an action plan that appropriately addresses his or her ability to succeed within the organization from the start. Your plan to integrate him or her into your facility should begin immediately following his or her acceptance of the job offer and incorporate the essential steps on the following slide. 1

64 ACTIONTO BE COMPLETED BY One of the most important documents a new hire needs is an official letter of hire from HR entailing the position, responsibilities, salary and specific hiring terms. This letter provides official documentation of employment, which is necessary for mortgage lenders, school enrollment, health insurance, benefits and utility activation, as well as other key tasks needed to settle in. Include a “Welcome” letter and an information packet containing information about the facility, community (background, traditions, observances), local site amenities (housing, transportation, schools, businesses, services, etc.) and other pertinent information about your site one month prior to the new hire coming on board. Include a Point of Contact such as a liaison or mentor at the facility. CEO/Clinical Director/Supervisor Identify staff with similar responsibilities to function as the new employee’s coach/mentor for work-related processes and procedures. CEO/Clinical Director/Supervisor Work closely with your HR representative and arrange to have all necessary paperwork ready for the new employee’s arrival.CEO/Clinical Director/Supervisor/ HR Representative Likewise, notify your IT department of the new hire and arrange to have all the necessary technology and telecommunications equipment set up prior to his or her arrival (computer, , phone, beeper, etc.). CEO/Clinical Director/Supervisor/ IT Department Prepare the new employee’s work area with any necessary office supplies prior to arrival date.CEO/Clinical Director/Supervisor Add the new employee to the department and/or unit’s organizational contact and routing lists within a week of reporting date.CEO/Clinical Director/Supervisor Schedule the new employee’s first week activities and prepare his or her agenda, including names, titles and departments/areas of key contacts with whom he or she will meet. CEO/Clinical Director/Supervisor Send an introductory to staff announcing the new employee’s arrival, function and location.CEO/Clinical Director/Supervisor Make plans to have lunch with the new employee or arrange to have lunch brought in to the facility for a meet and greet with the staff on the first day. CEO/Clinical Director/Supervisor Identify an appropriate community/facility representative to serve as a cultural liaison for the new hire. Arrange to have the chosen liaison available to meet with the new hire during his or her first week to ensure he or she has an appropriate understanding of the community and Tribal ways. CEO/Clinical Director/Supervisor/Cultural Liaison 1

65 The First Day While a new job can be exciting for someone new to your team, it can also bring an overwhelming sense of stress while trying to remember names, learn new processes and find his or her way around the facility. You can help to alleviate these concerns by putting the new hire at ease, assuring him or her that an organization chart is available to use as a “who’s who” resource and to map out each team within each department. Also, let the new hire know that you have an open-door policy should he or she have any questions or concerns. In doing so, you will immediately establish a sense of value and an understanding that your support is always available. 2

66 The First Day (cont.) Also, take the first day to confirm the new hire’s schedule, daily responsibilities and, if applicable, any previously agreed-upon telecommuting arrangement and then share that information with the HR department representative who’s responsible for going over the new hire’s employee orientation. It’s important to let the employee know that he or she should allow for a few hours that first day to go over all of the necessary documentation and employment benefits with HR. 2

67 ACTIONTO BE COMPLETED BY Be available to personally greet the new employee as he or she arrives. Schedule meetings, conferences and phone calls for later in the day. CEO/Clinical Director/Supervisor Personally lead the new employee through a tour of the facility. Orient him or her to specific locations, such as: Lunch/break room Bathrooms Conference rooms Office equipment and supplies Parking CEO/Clinical Director/Supervisor Introduce the new employee to the HR representative responsible for going over all paperwork, benefits, etc.CEO/HR Representative Introduce the new employee to all staff and the chosen mentor with whom he or she will work alongside.CEO/Clinical Director/Supervisor Orient the new hire to all technology: Phone/intercom systems Computer system Information technology/security Time-management software Meeting schedules CEO/Clinical Director/Supervisor/ IT Department Introduce the new employee to the executive staff: CEO (if other than the supervisor), CMO, CFO, etc., to acquaint him or her with management and to serve as a welcome to the entire facility team. CEO/Clinical Director/Supervisor 2

68 The First Week Orientation sessions aren’t just important to new employees. They’re also essential to the Indian health program because they address the organization’s policies and procedures, new-hire concerns and help staff members form accurate expectations about the job they’ve just taken on. Performing the tasks below will ensure that your new employees are fully on board right from the beginning. 3

69 ACTIONTO BE COMPLETED BY Meet to review and discuss the new hire's IHS orientation, including explaining the following: IHS Mission Introduction to IHS (IHS 101) Employee ethics Communication Customer service Supervisor Identify training and development activities needed within the first six months and sign up the new employee for appropriate classes. Supervisor Set performance expectations and discuss how and when the employee will be evaluated.Supervisor Review and discuss the employee’s first week, answer his or her questions and solicit his or her feedback.Supervisor Introduce the new hire to the community liaison chosen to help with his or her immersion to the community. Ensure the new hire understands the local traditions, heritage, cultural observances and ceremonies. Supervisor/Community Liaison 3

70 Within the First Six Months Inspiring a new employee to want to remain at your Indian health facility is an ongoing task. Retention is a process that must be actively nurtured and developed during the tenure of each employee. This includes giving your employees the attention they require and deserve, offering encouragement and support, acknowledging a job well done and ensuring that he or she has a voice within your organization and that his or her input — as well as the input of all staff members — is key to the success of your facility. In short — give your employees a reason to stay! 4

71 ACTIONTO BE COMPLETED BY Check in regularly with the new employee to see if there are any questions or concerns. Provide feedback often — including positive reinforcement. CEO/Clinical Director/Supervisor Schedule a six-month new-hire evaluation.Supervisor Provide monthly feedback to new employees, regarding their job performance, including a formal performance evaluation in their third month. Supervisor Celebrate each new hire’s six-month anniversary with a planned lunch or other form of recognition.CEO/Clinical Director/Supervisor 4


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