By K. Richard Douglas
The exodus of baby-boom generation biomeds from the profession threatens a staffing vacuum unless hundreds of replacements are located, trained and onboarded. With the shortage of biomeds, the competition for competent recruits, who will remain a member of staff for years, is intense.
New staff have to feel welcome, appreciated, acclimated, comfortable and a part of a team. The process of achieving all of these goals falls on management, leads and coworkers. The hiring manager needs a game plan to find, recruit, assimilate, train and retain good HTM professionals.
As experienced biomeds retire, the rotation of staff in biomed departments has to occur smoothly, without disruption or impact on service levels. In a survey conducted by AAMI last year, it was discovered that nearly half of HTM professionals are over the age of 50.
Retirements of older biomeds create a void that is difficult to replace with fewer HTM degree programs available than there were 10 years ago. Even with formal training curriculums, the opportunities offered by the profession are not known by most high school seniors.
The practice of finding candidates, onboarding those who qualify, and then retaining those recruits requires a well thought out plan of action.
Luckily, much of the brainstorming has been performed by other members of leadership who have created protocols and procedures that move the process along and help new adds-to-staff to feel like a contributing and welcomed member of the team.
At the 2022 AAMI eXchange, one of the sessions was titled: “Onboarding and Retaining a New Team Member.” The presenter was Mike Powers, MBA, AAMIF, CHTM, CDP, system director-field service in the healthcare technology management department at Intermountain Health.
Powers outlined the steps that a hiring manager should take, including how to make the first 90 days successful, how to deliver a work experience that is appealing to current jobseekers and what departmental and organization tools to use.
He says to contact new employees prior to their start day and welcome them to the team. Let them know what to expect on their first day and answer any questions.
Other members of leadership have their own systematic approach, utilizing ideas that streamline the process and prevent missteps.
“The way I handle this is to create a detailed on-boarding program. I have templates I use, but the process starts the minute they accept the position. I don’t want to start off on the wrong foot having a tech show up without access to the department, has to share a computer or borrow tools,” says Ken Mylar, MBA, CHTM, CBET, system director of healthcare technology management (HTM) for Summa Health in Akron, Ohio.
He says that they have a checklist with required-by dates that will line up with the technician start date, 30-day review, 60-day review, and 90-day review that involves having their tools and test equipment audited before the start date and ordering anything needed, IT equipment accessed and ordered, badge office notified of required access needs, IT services setup as well as all predefined training needs for Summa Health and the department.
“Once the email account has been set up, various emails are sent to the new hire before they start with all of the links they would need for our CMMS, service manual site, share drive locations, parts ordering portal, etcetera. We also print a new hire orientation binder with a cover page with their name printed on it; which is a nice touch,” Mylar says.
He says that this binder has the new hire checklist, upcoming items to look for over their probationary period, phone directory of the department, cost centers and ordering accounts, department policies and practice pointers.
“There is a calendar invite sent out for one of their first days to review this binder and polices. There are also invites sent out for their 30-, 60- and 90-day reviews so everything is laid out in advance of them starting,” Mylar says.
Powers says to schedule conversations at 30 and 60 days to continue to engage a new employee, clarify expectations, provide performance feedback, and set and review goals. These discussions can be delegated to a mentor, educator or team lead, if appropriate.
He says to discuss career development and long-term goals.
“Schedule development conversations at 90 days, and regularly thereafter, to discuss your new employee’s professional and career aspirations and long-term goals,” Powers suggested in his presentation.
Mylar says that generally, new hires shadow another technician or multiple technicians for at least 60 days and then the department look at equipment and department assignments to have them go on their own when possible.
“We also start looking out for the need for any potential service training. Our entire health system is standardized to one monitoring system manufacturer, and their training center is close by, so we try to get all of the technicians any service training that is needed,” he says.
Powers suggests that management find a more tenured employee who can act as a mentor and “introduce the new person around,” as a good step. He says that the hiring manager could have lunch with them the first day.
Better Total Package Will Save Money
While new employees increase a department’s budget, they also can be a means to reducing the overall budget. Combined with good benefits, biomed departments can make themselves an attractive place to work and create staffs that satisfy upper-management’s goals.
“The benefits are becoming just as important as the pay, and the two go hand-in-hand. If your benefits are average, then you may have to offset with better pay. Organizations are struggling to hire talent. A dollar or two could be the difference between retaining an employee or losing them to a competitor,” says Matthew Kenney, CHTM, MBA, director of HTM at Aiken Regional Medical Centers in Aiken, South Carolina.
He says that HTM departments need to do a better job of setting new employees up for success.
“That means a thorough orientation when onboarding, explaining expectations and giving a 30-, 60- and 90-day evaluation. The evaluation piece is so critical in the success of each new employee. We have all been new to a job at one point. We know the importance of proper orientation to department policies, procedures, test equipment and even departments that need extra care and attention,” Kenney says.
He says that you have to have the buy-in from your C-suite.
“However, I’ve noticed since COVID, that the C-suite is looking harder to save money. One way to do that is to eliminate contracts. No one will sell your department capabilities better than you yourself. Come up with a plan. CFOs love numbers. Show them the potential savings and cost avoidances. You will find that many of them will get on board very quickly,” Kenney says.
Refocusing the Hiring Process
Replacing staff can be an exercise in frustration.
Traditional methods of advertising positions or hoping to find available, trained biomeds through word-of-mouth can prove futile.
Finding new talent requires resourcefulness and thinking outside the box. Especially when the environment gets extra challenging; that is when to think creatively.
“We have experienced 95 percent turnover in the last three years, and it was very painful. There were many reasons for the turnover, from retirements, feeling overworked, refusal of the COVID vaccine, better wages somewhere else and wanting to only work part time,” says John M. Petersen MBA, MMIS, senior director of clinical engineering-Boise for Trinity Health.
This scenario required an effective strategy.
“Opened replacement position postings. Our positions stayed open for a very long time. We struggled with a lack of experienced applicants applying. We used contracted labor to cover the gap. The issue with contracted labor is you don’t know what you are going to get and there are learning curves that you never really get past,” he says.
Petersen adds that they then started an apprenticeship program, which gained interest in the department.
“We hired one of two that completed the program. We started a third apprentice in the program. We went to local colleges and trade schools that had an electronics program to present the opportunities. We hired four this way,” he says.
In addition to these ideas, Petersen says that they spent a great deal of time on LinkedIn reaching out to anyone looking for employment.
“We knew recruiters did this, so we also tried it. We did find three hires from this method. We were able to hire two trained technicians with limited experience that were temporarily in the area taking care of family that decided to stay and be part of the team,” he says.
“Since there was a lack of experience available, we focused our interview process on soft skills and interpersonal behavior. This has been the best part of the hiring. We now have a team that relates well together,” Petersen adds.
He says that the average age of technicians is less than 28 years old and what they lack in experience they make up in their excitement in starting a career.
“We do struggle on how to develop staff when the entire team needs significant development at the same time. In five years, we will have the most qualified and highly effective team we have had at our facility,” Petersen says.
Ascertaining the Right Fit
Several years ago, a study of employee satisfaction found that “appreciation” was ranked even higher than salary. Employees want to know that the company and management notice what the employee has achieved and appreciates their efforts and contributions.
This is an important concept for leadership to understand and it contributes substantially to employee satisfaction and retention.
“We need to understand that it’s important for a work/life balance. Directors and managers should make their departments feel like a family. Leader rounding is another important tool to ensure you know what is going on with your technicians; on a personal and professional level. This should be done at a minimum once a month. During that rounding you can ask about them having the tools needed to do their jobs. Remember it’s your management, but their labor. Set them up for success. Hear their concerns. Empower your employees to be part of changes. Remember you need their buy-in to make sure changes are successful,” Kenney says.
Powers addressed the importance of this kind of attention and appreciation in his presentation.
“Meet with your new employee at the end of the day to see how her first day went. ‘Tell me about your first day?’ ” he suggests managers should ask the new employee.
He says that the first-day discussion should also lead to the next get-together. “Let’s get together in the next week or two to talk about,” Powers says, leading to subject matter that resulted from the first-day discussion.
He also suggests ways to help the new employee to feel a sense of accomplishment that will lead to more job satisfaction.
“New hires have almost a week of online training – how to be compliant with OSHA, how to not fall victim to email phishing, code red/blue/green, etcetera. Completion of these tasks, and sitting to discuss any questions that have arisen, leads to a sense of accomplishment,” Powers says.
Powers says to check with your human resources department to enroll a new employee in facility-specific onboarding events such as breakfast or lunch with the CEO.
After the first week, Powers suggests that there are three possible outcomes that reflect the new hire’s performance on the job. He says that either management is hearing great things about the new employee, that the employee is not meeting the needs of the position or department or management is not hearing any feedback. This is what he suggests as a response to each scenario.
Your employee has been on the job a week and you’re hearing great things?
“Don’t underestimate the value of recognition. Reinforce good behaviors. Document employee successes so they can be included during the annual performance review process,” he says.
You’re concerned about an employee who is not meeting the needs of the position or department?
“Meet with the employee to clarify expectations. Try to determine if they have the right tools to do the job effectively. Determine if they need additional training. Help your employee align their individual performance with the goals of the team and organization. Remember it is about the task or behavior not the person’s sense of self or character,” Powers explains.
Your employee has been on the job a week and you’re not hearing anything?
“Have a conversation about how things are going. Inquire about what’s working or what further training is needed. Provide support to the employee without removing responsibility,” Powers says.
The dialogue does not end after the first week but includes continuous recognition, interaction and support from management.
“I meet with my team of direct reports quarterly – yes, the entire team. I also ask each member of my team to have four annual goals, three professional [and] one personal that I can support them in reaching,” Powers says.
He says that at the end of the first quarter – 90 days, we should expect some defined goals and be on the path to completion of at least one.
“I like to discuss what is going well, and co-develop strategies that will enable the reproduction of good outcomes. I like to discuss what is not going well, and co-develop strategies to do something differently next time around. I like to make sure that we discuss the individual, shop, department and organization so that each individual knows how each one of those layers is doing and how they fit into that overall picture,” Powers says.
He says that he likes to check on the progress for achieving goals and discuss assistance needed to accomplish them.
“I like to solicit feedback on how I am doing and if the individual is getting the support they need, and what I can do better,” Powers adds.
A methodical approach to the hiring process, onboarding procedures, employee appreciation, routine feedback and total compensation will all contribute to a satisfied employee who feels valued. At a time when there is a shortage of qualified workers, it is incumbent on the HTM manager to use all of these tools to remain fully staffed and able to respond to customer needs.
Fresh thinking and insights allow HTM managers to respond to this challenge.
