How to Hire, Pay and Assimilate 100 Nurse Practitioners and Physician Assistants in One Year! Jaimee Gertz, Staffing Specialist Karmen Reid, Compensation Director Mandy Verdick, HR Manager ASHHRA National Conference September 30, 2013 Class Objectives 1. Learn the elements of a total compensation package for this group, including market analysis and communication methods 2. Demonstrate how to leverage non-traditional recruitment tools to attract large numbers of Nurse Practitioners / Physician Assistants (NP PAs) 3. Take back ideas on how to create a support system for NP PAs to include orientation, practice integration, and ongoing professional development Agenda • • • • • • • About Mayo Clinic Background on NP PA project Compensation Program Recruitment Program NP PA Infrastructure Support Summary / Metrics / Next Steps Open discussion – hear from you about your successes About Mayo Clinic • • • • Serves > 1 million patients annually ~4,000 physicians and scientists Over 53,000 allied health staff (27,000 in RST) 1,165 NP PA Staff (563 in RST) About Mayo Clinic – Magnet Hospital Designation 100 Best Places to Work – Fortune Top 5 hospitals – US News & World Report Award for Innovation and Leadership in Interactive Recruitment • 2012 Candidate Experience Award • • • • Background on NP PA Project • “Perfect storm” – Need to improve patient access – Practice redesign – Cost containment efforts – Decrease in the number of hours Residents can work….. • Resulted in an imperative to hire 139 additional NP PAs in 2011 and 136 in 2012 and to retain existing 400 NP PA staff Agenda • • • • • • • About Mayo Clinic Background on NP PA project Compensation Program Recruitment Program NP PA Infrastructure Support Summary / Metrics / Next Steps Open discussion – hear from you about your successes Total Compensation Program • Wanted to ensure very competitive total compensation program for recruitment initiative – Base Pay – Hiring practices – “Add-ons” • Align more closely with Mayo in Arizona and Florida Base Pay • Do not differentiate between NPs and PAs • Needed subjective criteria for differentiation • Cultural practice to not pay by specialty – Everyone is “special” – Lack market data for some highly special areas – Perception of “value” • Salary model only (no RVU, production system) Base Pay – Market Approach • Target range midpoints at the market 60th percentile • Collaboration with leaders regarding market matching: NP PA type and geographic scope • Participate in national, local, regional NP PA surveys • Commissioned our own survey for this project • Openly communicate comp program and share market summaries with supervisors/managers Base Pay – Market Approach • Categorize by work unit schedule type: – Monday-Friday Day jobs – 24/7 jobs – Extended Hours jobs • Price job by matching market specialty to work unit type. Review at least annually • See example Total Compensation • • • • • • • “False” minimum when hiring (market practice) Impact when transferring High shift differential Extra shift payments (exempt) On-call and call-back Additional CME trip days with allocated $$ Student loan pay-back Communication • Use NP PA (supervisors) Council as “forum” – Annual adjustment – supervisor handouts – Market summary updates for decision-making – Share additional earnings data by department • Robust Compensation website and FAQs regarding NP/PA comp program on NP PA website Agenda • • • • • • • About Mayo Clinic Background on NP PA project Compensation Program Recruitment Program NP PA Infrastructure Support Summary / Metrics / Next Steps Open discussion – hear from you about your successes Recruitment Background • Prior NP PA recruitment relied heavily on journal advertisements and CME conferences – Expensive – Lacked ability to track effectiveness of $ spent • With the changing practice model, increased recruitment demand and availability of social media plus new tools/techniques, we enhanced our plan • Partnership with Jobs2web™ to help track analytics Implementation of Social Media • LinkedIn™ – Recruiter seat to connect with passive candidates – Company job posts for difficult to fill jobs – Sharing jobs with NP PA “groups” • Creation of NP PA Facebook™ page to promote jobs and Mayo CME • Twitter™ feed Other Web Sources • Mayo Clinic “Talent Community” – NP PA applicants receive email notifications of new NP PA job openings via email – 2010 = 434 members/ 2011 = 792 members 2012 = 1634/ 2013 = 2714 – 45% increase from prior year – 66% increase from 2012 to 2013 • Ability to search/message members based on specialty to promote openings Other Web Sources, continued • Career Builder ™ Source and screen services – ¼ cost of recruiting agency – Market only our job – Keep all sourced applicants for future use – Multiple hires for one price • Premium posting on aggregator sites – $100/job – Guarantee premium placement on applicant searches Internet Campaign • • • Maintain strong internet presence Pay per click campaign – 3 months, focused media plan based on research by J2W ™ – Blend of niche and aggregator sites, plus other internet sources NP PAs visit NP PA strategy and career web pages – Customized internet experience through career profile page with only NP PA jobs listed – Career profile pages - feature NP PA profiles and interviews Video Utilization • Mayoclinic/org site • Research indicates that job posts that include video are more likely to be viewed and capture the applicant Video Utilization, continued • MDPathways™ Platform – Build a library of employee videos to promote positions instead of using a job description – MDPathways™ advertises and pushes out emails with videos to their members/lists • Applicants relate to seeing who they would work with, hearing about the work environment • Likely to increase candidate engagement from video College Recruitment • No Nurse Practitioner or Physician Assistant school at Mayo Clinic • Mayo School of Health Science is affiliated with local programs to offer clinical residencies (rotations) to strong NP PA students • Not enough students applying to fill all open positions • Identified a need to partner with schools to advertise benefits and promote Mayo NP PA employment opportunities College Recruitment, continued • • • Implemented college recruitment visits twice yearly to Mayo affiliated NP PA programs Built plan to include engagement with non-affiliated NP PA programs by: – Completing an assessment to determine where majority of recent hires matriculated – Reviewing diversity statistics – Use of alumni/us to connect and build relationships with schools Email branded recruitment materials when visit isn’t possible Conference/CME Recruitment • • • Recruitment at local and national CME conferences – Utilize pre-and post attendee lists for email campaigns to share job information – Purchase banner ads or employer spots on Association website prior to the career or conference attendance to increase traffic Partner with an NP PA to speak about practice Promote Mayo benefits/ compensation and site awareness to help build pipeline even if no immediate hire result What didn’t work? • MD Pathways™ – Great concept – Little traffic that resulted in no hires • Career Builder™ Source and Screen – Lacked qualified, experienced candidates • Some niche websites • LinkedIn™ Jobs – Great profiles but found that healthcare providers were less active on this site What did work? • Pay per click campaign • Indeed™ premium posting • Conference/CME attendance – With help of pre-post conference advertisements – Email list to drive traffic to booth • College recruitment • Mayoclinic.org website and local association websites How do we know? NP and PA Applicant Visits by Source Direct Job Aggregator Email Pay-Per-Click Search Engine Social Network Industry Groups Other Job Boards - Niche Jobs2Web RSS Monster Hires by Source Career Site Services Career Site Direct Email Search Engine Other Job Aggregator Industry Groups Pay-Per-Click Social Network Job Boards - Niche Jobs2Web RSS Pay Per Click Results • PPC – launch 3 month campaigns, 2 times per year – Talent Community Subscribers = 162 – Applies = 148 – Qualified Apps = 79 – Interviews = 16 – Offers = 6 – Hires = 2 – Sources = Indeed.com, Simplyhired.com Hiring Results by Year Year 2010 2011 2012 Total Applicants Unique 1060 354 1259 511 1103 463 Interviews* 257 414 342 Hires* 108 139 136 Total Staff 405 487 563 New at Mayo for 2013 • iPad use at events to join Talent Community • Mobile recruiting • Continue pursuit of passive candidates (Practice Link, LinkedIn, HealtheCareers databases) • Development of branded recruitment materials specifically for NP PAs Key Learnings • Monitoring analytics is key • Continuing to adjust plan to keep up with new technology – Mobile recruitment (job website, QR codes) – Use of iPad and video to engage applicants • Market is competitive, our plan must adapt to keep pace Agenda • • • • • • • About Mayo Clinic Background on NP PA project Compensation Program Recruitment Program NP PA Infrastructure Support Summary / Metrics/ Next Steps Open discussion – hear from you about your successes NP PA at Mayo Clinic • Mayo Clinic is a physician-led organization • Departments are led by a physician Chair with an Operations Administrator (OA) for support • Allied Health Staff, including NP PAs, report to the OA or a supervisor reporting to the OA • NP PAs do not have a centralized reporting structure as they align with their collaborating or supervising physician and specialty NP PA at Mayo Clinic • • • • • • Role is used interchangeably within clinical practice Practice expectations are the same for both Reporting through the clinical department to the Operations Administrator, sometimes through an NP PA Supervisor Clinical partnerships with MDs NP PA Executive Committee designed to be an advocacy group for the NP PA practice at Mayo Clinic. Reports clinically to Clinical Practice Committee (CPC) and administratively to Clinical Administrative Leadership Group (CALG) NP PA Executive Committee The Nurse Practitioner and Physician Assistant (NP PA) Executive Committee is charged to: • • • • • • Promote and advance the professional role of the NP PA at Mayo Clinic Ensure alignment of NP PA practice with the Mayo Model of Care Review practices that may impact Mayo’s ability to recruit and retain NP PA staff Support development of educational programs for NP PA staff and oversee NP PA Education Council Encourage scholarly and research activity for NP PA staff Organize, lead and initiate the activities of the NP PA Council (NP PA supervisors and assistant supervisors) and NP PA Forum (for all NP PA staff) NP PA Executive Committee Membership • • • • • • • NP or PA Supervisor – Chair OA – Administrator MD - Medical Director HR – Secretary 2 Operations Administrators/Managers 3 NP PA Supervisors (Medical/Surgical/Primary Care/Hospital practice) Education Program Coordinators for NP and PA training programs NP PA (Supervisors) Council • Reports to Executive Committee • Consists of NP PA Supervisors, Operations Administrators and Operations Managers • Information sharing • Forum for networking and sharing of issues Practice Expectations • Defines role and scope through formal documentation • Collaborative Practice • Responsibility for Patient Care in both inpatient and outpatient settings • Exceptions to Practice Expectations are reviewed by NP PA Executive Team and approved by the CPC • Practice Agreement and Supervision • Provides clarity of expectations Site Visits • Executive Committee meets with NP PA Practices across the organization • 10-15 site visits per year • Overview of practice, strengths, opportunities, growth needs, physician/NP PA partnership • Provide a summary to Department Leadership • Offer follow up consultation to practices if needed Orientation Resources • • • • • NP PA Orientation Checklist Medical and Surgical Orientation Guide Online Training (within 30 days): – Confidentiality – HIPAA – Infection Control – Integrity Training – SBAR – Intellectual Property Form Completion Practice related policies Computer Training on EMR tools Orientation Resources Practice Specific Considerations • low frequency, high risk, and/or invasive clinical procedures in the practice • practice-specific software or equipment • clinical or research procedures in the practice • unique teamwork or reporting relationships • cross-coverage needs within the workgroup Education Council • Education Council was initiated to ensure educational needs of NP PA staff are met • Needs assessment was completed via survey of NP PA staff’s educational needs • Opportunities for staff education include: – NP PA focused CME courses – NP PA Inpatient Medical Grand Rounds – Bootcamp – Simulation Center training NP PA Leadership Development • Development of new supervisors and future leaders • Use of Mayo Leadership Development resources • Mentorship program for both new supervisors and current NP PA staff • Academic advancement Agenda • • • • • • • About Mayo Clinic Background on NP PA project Compensation Program Recruitment Program NP PA Infrastructure Support Summary / Metrics / Next Steps Open discussion – hear from you about your successes So …..Does it work? Metrics • Filled 139 NP PA jobs in 2011; 136 jobs in 2012 • Turnover = 4.1% • Satisfaction with pay = 79% (compared to 49% national hospital benchmark) • Turndowns = 19 Next Steps • • • • • Standardizing Mayo Clinic Health Systems Continue hiring - 29 openings Strengthen retention efforts Leadership development for NP PAs Staff development and mentorship program for NP PAs Agenda • • • • • • • About Mayo Clinic Background on NP PA project Compensation Program Recruitment Program Assimilation Program Summary / Metrics/ Next Steps Open discussion – Let’s hear from you about your successes Questions & Discussion