Mr. Chairman and Members of the Subcommittee:
Thank you for inviting CACI to contribute to the discussion on health care recruitment and retention. CACI has been instrumental in the advancement of recruitment marketing research, strategy and practice for more than 15 years. Our clientele include the National Security Agency, the National Guard Bureau, the Corporation for National and Community Service, and the Veterans Health Administration. My name is Jim Bender, and I am one of the architects of the VA Nurse Recruitment Pilot Study I will address today.
Given the impending retirement of the Baby Boom generation, in addition to severe shortages in certain health care occupations, we at CACI support efforts by the federal government and affected industries to advance recruitment marketing and retention. These efforts will help neutralize the competitive market pressures that would otherwise undermine the effectiveness of all but the highest paying health care systems in the country.
The national supply of health care professionals in certain fields – especially nursing – is not keeping pace with demand. In April of 2006, the American Hospital Association reported 118,000 registered nurse vacancies nationwide, a vacancy rate of 8.5 percent. The Health Resources and Services Administration projects a shortage of 1 million nurses by year 2020. As the nation’s largest health care system, the VHA has a major stake in this game.
In February of 2006, in response to the Veterans Health Programs Improvement Act of 2004, VHA’s Healthcare Retention & Recruitment Office contracted with CACI to conduct a pilot program to test and recommend innovative recruitment methods for hard-to-fill health care positions.
From a pool of 17 pilot site applicants, the North Florida / South Georgia Veterans Health System was chosen as the pilot location. The system’s unique recruitment challenge was finding nurses with enough experience to fill higher-level nursing positions.
Our objective going into the North Florida / South Georgia system was to test methods to enhance effectiveness in four key areas:
- Employer branding and interactive advertising strategies
- Internet technologies and automated staffing systems
- The use of recruitment, advertising and communications agencies
- Streamlining the hiring process
Subsequently, the study was divided into two distinct operations. One was focused on recruitment marketing, with the goal of increasing the number of qualified applications coming into the system. The second was business process reengineering, with the goal of decreasing the administrative time between application receipt and job offer. An abundance of anecdotal evidence suggests that VA loses good candidates because of the lengthy boarding process.
The program was conducted over 60 days, beginning Feb. 5, 2006. All activities were monitored and measured to evaluate results.
On the recruitment marketing side of the operation, the findings were exceptionally optimistic.
- The recruitment marketing campaign generated 10,261 inquiries into nursing positions for experienced nurses. An inquiry was defined as a response to recruitment advertising or similar communications outreach.
- Of those inquiries, 115 candidates submitted applications.
- Most impressive was the percentage of applicants uniquely qualified to fill the advertised positions. During March of 2006, the only full calendar month of the study, the number of applicants for Nursing Services who passed the initial screening process increased by 83 percent over the month prior (from 12 applications to 22) and 300 percent over the trailing five-month average (from 7.4 applicants to 22 applicants).
The recruitment methods that garnered these results include a strategy based on the principles of employer branding and market segmentation, in addition to vigorous use of interactive media and Internet technologies, which delivered the highest return on investment of any media in the study.
The pilot program recommendations embraced these methods and further suggested the use of database marketing, relationship building (especially with the student population), employee referral programs, budget modifications and improvements to organizational communications.
On the business process side, the results were equally optimistic. A comparison of current hiring processes to what-if scenarios revealed that a small number of process changes could significantly accelerate the time-to-hire:
- The average time-to-fill for new hires can be reduced from 72 days to 25 days.
- The average time-to-fill for employee transfers can be reduced from 33 days to 13 days.
The process changes that would actualize these what-if scenarios include the delegation of approval authority for routine recruitment activities, the implementation of an automated recruitment management workflow system to eliminate delays in paper-based mail and processing, a change in the timing of the VetPro credential verification process, and several modifications to standard processes that build delays into the system.
We at CACI believe health care recruitment at VHA is both strong and spirited. HRRO, in addition to the exceptional staff and leadership at the North Florida / South Georgia system, embraced this project with enthusiasm and sustained intellectual vigor. Since the pilot’s conclusion, we have seen continued movement toward the methods tested in the pilot project – including increased use of targeted email communications, expanded use of online job postings and greater promotion of employee referral programs – as well as a persistent hunger for new, progressive ways of engaging health care professionals.
In closing, thank you once again for the opportunity to present CACI’s conclusions from the Nurse Recruitment Pilot Study, and thank you for the opportunity to contribute to the continued health and welfare of our country’s veteran population. I look forward to your questions.