Health Care Human Resource Management

Chapter 4

Niles, N. J. (2013). Basic concepts of health care human resource management.

Sudbury, MA: Jones and Bartlett.

Introduction

Recruitment is an organizational process of attracting applicants for job openings in an organization. Selection of the appropriate candidates occurs from a pool of qualified applicants (Byars & Rue, 2006). The main goal of the recruitment process is to generate a qualified pool of applicants to select from to support the success of an organization. For the recruitment process to be successful, it is important that the recruiters use job analysis to develop appropriate job openings to attract qualified applicants (Fried & Fottler, 2008). The next step is to select the best potential candidates for the organization. The recruitment and selection processes are priorities of any organization. This chapter will describe the steps in successful recruitment in healthcare organizations, the sources of recruitment, successful recruiter characteristics, a legal selection process, and the importance of hiring a diverse workforce.

 Recruitment Methods

Organizations recruit both internally and externally. Internally, organizations recruit in three ways. First, organizations ask current employees for referrals. Most referrals will be quality referrals because a poor referral will reflect poorly on the employee. If the referral is successful, the organization may reward the employee for the successful referral. Second, management will promote from within the organization. Organizations like to reward quality employees with a promotion or transfer to a new job. This can be an advantage to the organization because the employee is already familiar with the organization and is a known entity to the organization. Promoting from within is an incentive for all employees to work harder. Internal recruitment is also less expensive and less time consuming. The only potential disadvantage of internal hiring is when an organization is changing its organizational culture or strategic plan. It could be a disadvantage to promote an existing employee, as she or he may have an established organizational mindset.

Third, an organization will hire from its internship program. Many organizations offer either paid or unpaid internships, which are often a 6- to 12-month position in an organization usually staffed by graduate and undergraduate college students. Internship programs are typically a partnership between an organization and an educational institution where the student works part-time and receives educational credit for the work. The partnership agrees upon designated work activities for the student. It gives the student an opportunity to experience healthcare working conditions and provides him or her a glimpse into “real-life” experiences. It also provides an opportunity to observe whether the student would be a good employee for the organization. Some universities require students to complete an internship as part of their graduation requirement (Dessler, 2012).

External recruitment can be obtained from many different sources. Advertising in designated publications (print media) has been common for decades. Targeting of clinical publications for nurses and physicians, for example, is a common way to recruit. However, what has become more common is job postings placed on an organization’s website. It is less expensive and can capture a larger population. However, the downside of electronic job postings is that a posting can generate hundreds of unqualified applicants. In addition to placing a job posting on the organization’s website, the organization will also place an electronic posting on a career website. For example, the career site  http://www.gohealthcarejobs.org  has postings for healthcare jobs nationally.

Government Sources

Local, state, and federal government employment departments are used when recruiting for government openings. They post positions on their websites for both external and internal openings. The websites for federal government openings are http://federaljobs.net/federal_jobs_opening.htm and http://www.usajobs.gov. Local government agencies also use local information cable channels to broadcast openings in the local area.

In 2001, Children’s Hospital in Boston implemented a shadowing program to recruit nurses from hospitals. The organization advertises the program in the local newspaper or online, asking if any nurses are interested in following a nurse employee for a day while the nurse employee is performing a typical daily work routine. Nurses who visit also meet with the management of the surgical program to learn about the program. This also provides an opportunity for the hospital to assess the visiting nurses in a clinical setting (Shermont & Murphy, 2006).

Private Employment Agencies

Organizations use private employment agencies to recruit both senior-level and lower-level employees. Agencies often charge an expensive fee for their services, but they are responsible for the entire process and typically generate very qualified applicants.

Temporary Employee Services

Temporary employee agencies provide employees for short-term and long-term assignments in all industries. They charge a company a designated wage for the employee and are responsible for paying the temporary employee’s wages. The temporary employment agency often provides employee benefits. For example, Maxim Healthcare Solutions, established in 1988 because of the continued nursing shortage, is the largest private employment agency nationally. It places qualified medical personnel for both temporary and permanent assignments (About Maxim, 2011). When a company like Maxim Healthcare Solutions places a short-term employee in a healthcare organization, it provides an opportunity for the company to observe the employee to assess his or her work ethic and to determine if the employee would fit in the organization.

Educational Recruitment Activities: Job Fairs

Many healthcare organizations will hold job fairs at educational institutions that have healthcare programs. The company recruiters will ask for graduating students’ résumés and will conduct interviews at the job fair. They may also ask students to sign up so the job recruiters can decide prior to the event exactly who should receive an interview.

 Direct and Indirect External Recruitment Methods

There are direct methods of recruiting, which consist of an organization actively searching for candidates for specific job openings. There are also indirect methods of recruiting such as establishment of a social mediapresence (Byars & Rue, 2006). Historically, organizations would place job openings in newspapers and trade publications, which were often expensive. Electronic job recruiting is more common because it is cost effective.

Many organizations post their job openings on their websites for public viewing. It is one of the most inexpensive ways to post jobs. Organizations may also post jobs for internal application only, meaning that only existing employees can apply. In addition to company recruitment, electronic job recruitment occurs on general career websites such as Monster.com and careerbuilder.com. Many healthcare recruiting sites focus on certain healthcare jobs such as nurse, physician, and chiropractor. The following are only a few examples of the diverse opportunities for electronic job recruitment:

• http://www.nationalmedicalsearch.com: A national search agency that recruits physicians and nurses.

• http://www.foundationmedicalstaffing.com: Recruits specifically for the dialysis industry.

• http://www.soliant.com: Recruits for specialty professionals nationally.

• http://www.ihrcanada.com: Recruits healthcare professionals for the Middle East.

Electronic Job Fairs

The electronic job fair is a newer method of job recruitment. Electronic job fairs are similar to traditional job fairs because they have a designated target and city and designated dates with specific hours for the contact. Typically, employers are charged a fee for participating in the electronic job fair, but the fees are approximately one third the cost of a traditional job fair because the electronic job fair eliminates travel and setup costs (ejobfairs.net, 2011). The job seeker pays no fee. The job seeker signs up on the website, uploads his or her résumé, creates a generic introduction, and then searches for electronic job fairs. Employees contact company recruiters directly and interview electronically. Users can follow, for instance, ejobfairs.net on Twitter.

Social Media

An indirect method of recruitment is the presence of healthcare organizations on Facebook, Twitter, and LinkedIn. The Cleveland Clinic, which is one of the most highly regarded healthcare systems worldwide, is progressive in its use of electronic media to recruit potential employees. On its home page, there are links to social media outlets and a link to careers at Cleveland Clinic (http://www.clevelandclinic.org). Its Facebook page promotes the organization and educates consumers about their health. Its LinkedIn page focuses on past and present employees of the clinic, which gives them an opportunity to network with each other. Its Twitter home page has links to the Centers for Disease Control and Prevention and to other government agencies that focus on health issues. The Cleveland Clinic is marketing itself via these electronic venues.

Health on the Net Foundation

Created in 1995, the Health on the Net Foundation (HON) is a watchdog of online health organizations. The Economic and Social Council of the United Nations accredits this non-governmental organization, which focuses on ensuring that healthcare information is reliable. The foundation’s HON Code of Conduct certifies that an organization’s website complies with eight principles, which are as follows:

1. Information is provided by qualified authors.

2. Information supports but does not replace the doctor–patient relationship.

3. The confidentiality of website users and visitors is maintained.

4. Information is sourced.

5. The site supports any performance claims.

6. Contact information is available.

7. Funding sources are identified.

8. Advertising policy is clear.

The foundation also has HONsearches, HONtools, and HONtopics—all guaranteed by HON to be correct (HON Code of Conduct, 2011). This type of certification is another way of marketing an organization. HON has certified the Cleveland Clinic. It demonstrates the quality of the Cleveland Clinic. Job seekers are attracted to an organization that supports ethical behavior.

Successful Recruiters

Recruiters are designated employees or human resources (HR) specialists who are responsible for attracting the best employees to their organizations. They are considered to be the face of an organization, and it is important to select the appropriate employees to recruit new employees. Although many recruiters work in an HR department, research indicates that candidates prefer to be interviewed by employees who work in different departments in an organization, although assembling a team of recruiters that includes an HR specialist who is familiar with HR policies and procedures may be an option (Noe, Hollenbeck, Gerhart & Wright, 2012a).

Michael Homula (2005) stated there are several characteristics that successful recruiters possess including excellent oral communication skills, the ability to develop a rapport with the candidates, the ability to be a good listener, loyalty to the organization, the ability to interpret the nonverbal behavior of candidates, understanding of the organizational culture, and dedication to recruiting the best possible candidates for the organization. It is important for an organization carefully to select the best employees for this type of activity and to provide training, if necessary, on successful recruitment methods.

 Recruitment Evaluations: Source Yield Ratios

There are many employee recruitment methods used in the healthcare industry. Print media include trade magazines, social media, company websites, career fairs, and employment agencies. A company will analyze which of the methods produces the greatest number of qualified employees to interview and consequently hire. Source yield ratios, calculated as percentages, evaluate the type of recruitment activity that ultimately produces a candidate that accepts a position with the company. For example, a company will calculate a source yield ratio for external recruitment methods such as advertising in a trade magazine or using the Internet. The source yield ratio can also be calculated for internal recruitment methods such as employee referrals or internal job postings. Tables 4.1 and 4.2indicate the source yield calculations for both external and internal recruitment methods. Table 4.1 reveals that advertising in the trade magazine and on the website produce a source yield of 10% and 20%, respectively. Table 4.2outlines the calculations for internal recruitment of employee referrals and internal job postings, which produce a higher source yield ratio of 50%. Each step in the process could also be calculated using the source yield ratio. Of the number of applicants, a source yield ratio could be calculated for number of interviews accepted, the number of applicants who receive offers, and the number of new hires. A higher percentage indicates the method is an effective way of finding new hires (Source Yield, 2011).

Table 4.1 Source Yield Ratio Examples: External Recruitment

	Trade Magazine	Internet Website
No. of applicants	100	1000
No. of hires	10	200
Calculation	10/100	200/1000
Source Yield Ratio	10%	20%

Table 4.2 Source Yield Ratio Examples: Internal Recruitment

	Internal Job Postings	Employee Referrals
No. of applicants	50	20
No. of hires	25	10
Calculation	25/50	10/20
Source Yield Ratio	50%	50%

In addition to the source yield ratio analysis, the cost of each recruitment process must also be analyzed. Budgeting is always a concern for recruitment. If the company were recruiting for a senior management position, it would most likely spend more money on the recruitment and hiring process. If the recruitment were targeting lower-level positions, then the company would likely spend less on the recruitment process, which is not always the most prudent decision, particularly in health care. There is so much teamwork involved in health care that employees at all levels in a healthcare organization play a role in patient care, and therefore it is important to place a priority on recruitment at all levels.

Typically, the most expensive recruitment method is using an employment agency, and the least expensive is electronic job posting because this is often a feature of a company’s website. The company may decide to pay a fee, which varies, to post an opening on a career website. The organization must track the recruiting expenses of a position and calculate how many candidates were hired. Another factor in determining the success of any recruitment process is the time required to complete a process successfully. In a recent survey, it was determined that employment agencies often take 30 days to hire and the Internet took only 12 days, so time also needs to be factored into the evaluation process (Mathis & Jackson, 2006).

 Selection Process

The selection process consists of choosing the best individuals for an organization. The recruitment process is implemented to find the best employee. There is a strong linkage between recruiting and selecting. If there is a poor recruitment strategy, there will not be a qualified pool of applicants for selection. As with any human resource management process, there should be collaboration between the HR department and the managers of the organization. Once the recruitment process is completed, the organization will have a pool of applicant résumés to review. A generic selection process consists of (1) initial screening of the applications, (2) interviewing qualified applicants, (3) administering any tests, (4) conducting a reference and background check, and (5) offering a job to the best individual (Dessler, 2012). If an organization has a designated HR department, then there will be an initial screening of the résumés by HR to determine which candidates are qualified. If there is no HR department, there will be a designated individual or committee to screen the applications. To ensure reliability and validity in the process, organizations use a résumé rating tool for candidates’ résumés. The tool provides a standardization of the résumé evaluation process.

Based on the job description and job specifications, a tool, either electronic or manual, is developed. All applicant résumés are rated to determine if applicants meet the specifications of the job and if they have the skills to perform the job. In some organizations, there will be a telephone interview as part of the screening process. Once the résumés are initially screened for qualifications, then telephone or videoconferencing interviews may occur to screen the candidates prior to inviting the top prospects for a face-to-face interview.

Types of Selection Tests

As part of the selection process, different tests will be administered to applicants. Physical ability tests focus on strength and endurance such as that for carrying and lifting of equipment. Psychomotor tests measure a person’s hand–eye coordination. Aptitude tests may be given to assess a candidate’s ability to perform a certain task such as laboratory analysis or reading X-rays. There is also a healthcare aptitude test, which analyzes the ability of individuals to be compassionate with patients and their ability to work with teams (employtest.com, 2011). Cognitive ability tests measure memory, critical thinking, and verbal and math comprehension, which applied to an organization includes problem solving, planning and organizing, and reasoning. Research indicates that these tests can accurately predict job performance (Arnold, 2011).

Rather than implementing individual selection tests, identity (attitude and aptitude) tests have been developed that assess not only cognitive ability but also risk profiles for drug use and workplace violence, service and helping orientation, team player potential, trustworthiness and reliability, workplace skills, and workplace personality, and these tests can be customized for the healthcare industry (totaltesting.com, 2011).

Personality tests assess an applicant’s characteristics that could affect the work environment. The test scores are based on 100% with an average score of 50%; therefore a score of 70% would indicate a higher demonstration of a particular personality trait. Personality experts have developed a set of personality traits that demonstrate different levels of performance in the workplace in different job positions. These Big Five Personality Traits include extraversion, conscientiousness, agreeableness, emotional stability, and openness to experience. Extraversion refers to the degree an employee is open and outgoing and is energized by relationships with other employees. Applicants who score high on this test would more likely perform better in sales, management, and teamwork. Those who did not score high may be more suited for research positions, which have less interaction with other employees. Conscientiousness measures how goal oriented an individual is and if he or she is disciplined in the workplace. These types of employees are an asset to any organization and are very suitable for teamwork. Agreeablenessmeasures an employee’s sensitivity to other employees, whether he or she succumbs to peer pressure, is willing to help others, and has a positive attitude toward others. These types of employees work well in team situations. An applicant who scores high on emotional stability indicates a high tolerance for stressful situations and heavy work demands. Such individuals perform well in different industries including health care with its stressful environment. Openness to experience indicates an applicant’s preference for a variety of responsibilities in his or her job description. Such individuals would perform well in a job redesign such as job enrichment or job enlargement. They tend to be very imaginative and are sensitive to the emotions of others. Applicants who score high and low on this trait tend to perform well in teams; however, those who score high on this trait tend to ignore rules (Hitt, Miller & Colella, 2006). Lievens, Coetsier, Fruyt, and De Maeseneer (2002) performed personality tests on 800 premedical students studying at five universities, and the results indicated that students who scored high on their clinical exams also scored high on extraversion and agreeableness. Medical students who scored low on conscientiousness and openness to experience scored poorly on clinical exams. Lievens and colleagues’ conclusions indicated that the test results were indicative of medical students’ performance in the medical field.

The Big Five Personality Traits could also be used as a basis for developing interview questions to assess the type personality of the candidate. For example, if the interviewers would like to investigate the conscientiousness of a candidate, the questions would focus on whether the candidate likes to be prepared for a situation, if he or she pays attention to details, accomplishes tasks immediately, likes order, and is precise in his or her work. If the interviewer were interested in emotional stability, the questions would focus on mood swings and reaction to pressure. Openness to experience questions would probe if the candidate is imaginative, is creative, and follows rules and regulations. Agreeableness characteristics could be revealed by asking questions about empathy, making people feel comfortable, and compassion. Although a company could perform a valid and reliable Big Five Personality test, asking interview questions that focus on these characteristics as well would support any personality test results.

Honesty Tests

Many companies are now using honesty or integrity tests with applicants, although there have been questions about the validity of these tests because applicants can fake honesty on the tests. Companies use these tests as a statement to applicants that dishonesty is not tolerated in the organization. Because their validity has been questioned, it is important for these tests to be only one component of the whole process (Mathis & Jackson, 2006).

Background Checks

Background checks consist of verifying information on the applicant’s résumé, asking for academic transcripts, speaking with those given as references, and running a credit check. The applicant is told that a background check will be performed. An in-depth background check or criminal background check may also be performed to assess any past criminal offenses. The applicant must acknowledge in writing that a criminal check will be performed. More companies are performing a criminal background check because if an individual is hired and acts illegally or hurts another employee, the company could be held liable for not providing a safe working environment. The author has been involved in hiring processes where the candidate has withdrawn from the process because he or she learned that a criminal background check would be performed; thus, these checks can be a deterrent for applicants that may not be suitable for an organization. Although most companies require references from former employers, some former employers have been sued for providing a poor reference, so many former employers now only provide general information about when a former employee worked for the organization and his or her position and responsibilities (Mathis & Jackson, 2006).

 Interviewing Candidates

Once the screening occurs, a list will be prepared of candidates to be invited to an interview. Usually, the employees of the department needing the new employee will participate in the interview. If the organization has an HR department, the interviewers will be trained by HR. Interviews can be held by individuals or by a panel. The interviews can be face to face or by telephone or another electronic method. Interviewers can ask very structured or unstructured questions. Regardless of the type of interview, it is important that there is validity and reliability in the process.

Types of Interviews

Structured interviews are standardized questions that all interviewees must answer. Standardized questions allow a comparison between the candidates. The questions are prepared in advance. A situational interview is a type of structured interview that consists of structured questions that focus on how the applicant would behave in certain situations. An example of a question in a situational interview for a nurse candidate is the following: “If your shift replacement, who is the daughter of the nurse manager, was consistently tardy, how would you handle the situation?” A behavioral interview is similar but focuses on how the candidate handled a situation in his or her past. An example of a behavioral question would be the following: “Describe your behavior when you had to deal with a difficult patient.” Structured interviews are more reliable and valid because there is standardization (Byars & Rue, 2006). Unstructured interviews consist of the interviewer asking the applicant questions based on answers to previous questions. There is less preparation for this type of interview. Although the interviewer may obtain valuable information about the applicant, it is difficult to compare applicants for the same position using this type of interview. Table 4.3 lists some typical questions the author has commonly asked candidates.

Table 4.3 Common Interview Questions

What are your strengths and weaknesses?

How can you contribute to the success of this organization?

Why do you want to work for us?

Describe a situation that you were in within the past 2 years that demonstrated your leadership.

Have you ever had to discipline someone? Describe the situation.

If your boss asked you to do something that may be illegal, what would you do?

What skills do you have that would contribute to the success of this job?

Define ethics in your own words.

Why did you decide to choose health care as your career?

Why are you leaving your current job?

 Validity and Reliability of the Employment Process

Every component of the employment process must be job related to avoid any issues of discrimination. To ensure that a step in the process is objective, it is important to assess the validity and reliability of the step. The term validity is a statistical term that refers to the extent a measurement such as a test actually measures what it says it measures. Reliability is a statistical term that refers to the extent that the same measurement such as a test repeatedly measures the same characteristic if the test is given multiple times to different individuals. For example, valid and reliable employment tests such as selection tests must evaluate the actual skill or trait repeatedly regardless of who is taking the test (Mondy, 2012).

Content and Criterion Validity

Content validity is developed when a selection tool evaluates skills or knowledge that is used in a job application. For example, X-ray technician applicants may be asked about how to take an X-ray or a nursing applicant may be asked about how to take blood from a patient. The test will ask questions related specifically to activities related to a job. A selection tool must also have criterion-validity, which means that the scores on a test will be related to job performance predictions. If applicants score poorly on a test, they most likely will not perform well on their jobs, and if they score high on their test, their job performance will be high (Dessler, 2012).

Once a candidate is hired, the selection tool’s results will be compared with the actual job performance. The comparison will be measured by a correlation test, which examines the relationship between two factors such as test results and job performance. Correlation coefficients always range from –1 to +1. The sign of the correlation coefficient (+ , –) defines the direction of the relationship, either positive or negative.

Taking the positive aspect of a coefficient relationship, a correlation coefficient of 50% or less indicates a low correlation; 51% to 79% indicates a low to moderate correlation; 80% to 89% indicates moderate to strong connections between two factors; and greater than 90% indicates a very high correlation between two factors. Therefore, a higher percentage score for the selection test and job performance correlation indicates the selection tool should be used.

 Legal Ramifications of the Selection Process

The selection process must be legally defensible, which means the process must be objective and fair to all applicants (Noe, Hollenbeck, Gerhart & Wright, 2012b). The Equal Employment Opportunity Commission (EEOC) is the federal commission that monitors and enforces labor regulations to ensure that the employment process is non-discriminatory, which means that every component of the process must be objective and that no protected-class individual who is qualified is excluded from the process because of a flawed step. Therefore, all solicited résumés that are submitted for a job opening must be reviewed objectively to ensure there are no biases in the process. Protected-class applicants may question why they did not receive an interview if they felt they were qualified for the job. If the selection process is rigorously maintained with documentation at all steps of the process, the company and the employees will be protected. Table 4.4 is a job interview rubric to assess each candidate’s performance. This supports the legally defensible process of selection. Using a standardized tool such as the rubric enables the interviewers to compare the performances of the various candidates for a position.

 Characteristics of Good Interviewers

Similar to the recruitment process, the use of effective interviewers is very important to attract high-quality candidates to accept positions with an organization. Like the recruiters, it is important that the interviewers receive training to ensure they ask the appropriate questions and are comfortable with developing a rapport with the applicants to encourage quality responses. It is also important that the interviewer be prepared. The interviewers should review all résumés so that they are familiar with each candidate. Using a résumé review tool is an excellent method of providing inter-rater reliability of the reviewers. Table 4.5 and Table 4.6 provide an example of a tool that is used when reviewing a résumé that was submitted to a job posting. The tool uses the posting information as the parameters for determining if an applicant is qualified for a job opening. Using the job posting in Table 4.5 as the basis for the review tool, a panel of reviewers will have standardization when reviewing several applicants.

Table 4.4 Job Interview Assessment Rubric

Table 4.5 Example of a Job Posting

HEALTHCARE INFORMATION TECHNOLOGY DIRECTOR

JOB IDENTIFICATION:

Company: Health Is Yours Hospital

Location: Lady Lake, FL 32159

Job Type: Full-Time Title: Healthcare Information Technology Director

JOB DESCRIPTION: Implementation of an electronic health record system for a large hospital.

MINIMUM JOB SPECIFICATIONS FOR POSITION:

• Master of Science in Healthcare Informatics.

• 5 years of experience in IT management in a hospital setting.

JOB RESPONSIBILITIES:

• Manage the evaluation process of current patient system for electronic data system transfer.

• Make recommendations to senior management regarding electronic health record software.

• Develop training program for clinical staff for EHR software.

• Direct supervision of 10 IT staff.

• Implement new EHR system.

PREFERRED JOB SPECIFICATIONS:

• 10 years of management experience in hospital data systems.

• 5 years of supervisory experience.

• 2 years of experience with EHR systems implementation.

• Ability to manage a complex IT system using analytic and problem-solving skills.

• Excellent oral and written communication skills.

Please submit cover letter, résumé, and three references to:

http://www.HealthisYours.org/careers/InformationTechnolgyDirector Any questions: Call the HR Department at 864-555-2000 or e-mail [email protected]

Table 4.6 Résumé Evaluation Tool: Information Technology Director

Table 4.7 Common Questions Asked by Interviewees

What is the turnover rate for your company?

How would you characterize your organizational culture?

Do you promote from within the organization?

How do you see me fitting into your organization?

Where do you see your organization in 5 years? 10 years?

What type of training and development do you offer employees?

In addition to the review process, good interviewers should be familiar with potential questions interviewees may ask them about their organization. Table 4.7 provides examples of typical interviewee questions. The HR department can provide training to the interviewers regarding the importance of representing the organization in a professional manner.

 Hiring Diverse Employees

To attract a diverse pool of applicants, management and HR should develop a recruitment and selection plan. The following are tips that can support the organization as an equal employment opportunity employer:

1. Equal employment opportunity statements: The company should have a diversity policy on its website and on its individual job postings. The statement should easily be found on the website. By including an equal employment opportunity statement on any job posting, regardless of where it is posted, the company makes a statement that it is proactive in creating a diverse work environment. For example, the American College of Healthcare Executives promotes diversity on its website and encourages healthcare organizations to follow its example (Increasing and Sustaining Racial/Ethnic Diversity, 2010).

2. Specialized publications: Placing job postings in magazines and on websites that target specific protected classes will increase the diversity of applicants.

3. Diverse recruiters: Sending diverse recruiters to job fairs that represent different protected classes will encourage diversity in job applicants.

4. Diverse interviewers: During the selection process, continue to demonstrate diversity by selecting a diverse pool of interviewers. This will encourage applicants that are more diverse.

Being proactive in diversity hiring practices will enable the organization to avoid any issues with discrimination. It will also acknowledge the increased diversity of patients in the healthcare industry.

 Uniform Guidelines on Employee Selection Procedures

In 1978, the EEOC published the Uniform Guidelines on Employee Selections to ensure there are fair selection processes for all components of selecting employees. The EEOC, the Civil Service Commission, the U.S. Department of Justice, and the U.S. Department of Labor have adopted these guidelines. These guidelines provide information on the issue of unfair selection procedures including disparate treatment and impact. They have been modified over the years to reflect Supreme Court decisions related to employment discrimination (Mondy, 2012).

 Disparate Treatment and Disparate Impact

Disparate treatment occurs when protected classes (race, color, religion, sex, or national origin) are treated differently from nonprotected classes. For example, a female candidate who is qualified for a job may be asked to perform a skill or take a test that a male applicant may not take and the male is consequently hired. This applies to all employment procedures including interviews, application forms, work samples, physical requirements, and performance evaluations.

Disparate treatment in the selection process occurs through intentional discrimination against a protected group. Disparate impact is the underrepresentation of protected classes in an organization’s workforce (Fried & Fottler, 2008). Disparate impact is determined by the four-fifths rule: If the selection rate for a protected class is less than four fifths, or less than 80%, of the hiring rate of the majority group, then disparate impact exists (EEOC Selection Guidelines, 2011) (Table 4.8).

 Bona Fide Occupational Qualification

There are exceptions to disparate treatment. A Bona fide occupational qualification (BFOQ) means that a particular characteristic allows an organization to discriminate against a protected-class individual. Title VII of the Civil Rights Act of 1964 states that employers can discriminate based on gender, religion, or national origin if the characteristic can be considered a BFOQ. Race is not included in this exception. For example, an organization would hire a male attendant for a men’s restroom. If a woman applied for the job, she would not be chosen. Religious institutions may decline to hire applicants who have different religious backgrounds than that of the institution (Dessler, 2012). Courts and the EEOC have been hesitant to allow organizations to prefer one gender to the other. There are exceptions to consumer preferences that are allowed in health care. In the obstetrics/gynecology field, courts have indicated that preferences of consumers are permitted in some instances related to the privacy of their genital areas. The healthcare industry has unique circumstances when it comes to consumer preferences and the comfort of exposing a patient’s body. Females may prefer female gynecologists, and, therefore, a healthcare organization may rightfully decline hiring a male gynecologist because of BFOQ (McLaughlin, O’Day & Shorter, 2007). There have not been many cases regarding this issue. It will be interesting to see what happens over the next decade as it relates to health care and consumer privacy.

Table 4.8 How to Determine if Disparate Impact Exists

Premise: A healthcare organization wants to hire 75 X-ray technicians.

• Of the 200 applicants that apply, 100 are male and 100 are female—all equally qualified.

• The organization hires 50 of the male applicants and 25 of the female applicants.

Step 1: Calculate the hiring rates of each group.

• 50 males hired/100 male applications = 50%, or 0.50

• 25 females hired/100 female applications = 25%, or 0.25

Step 2: Compare the hiring rates.

• The hiring rate of the female applicants was 25%, which means that one out of four female applicants was hired. The hiring rate of the male applicants was 50%, which means that one out of two male applicants was hired.

Step 3: Apply the four-fifths, or 80%, rule.

• Divide the hiring rate of the women (25%) by the hiring rate of the men (50%). The ratio is 50%. If the ratio between the protected class group, which is women in this case, is less than four fifths, or 80%, of the majority group, which is the male group, then disparate impact exists in the hiring process. The result of 50% indicates there is an unfair representation of the protected class (females) in this hiring process, which may indicate a discriminatory process.

 Conclusion

An organization should plan a systematic recruitment process to ensure that appropriate candiates will apply for positions. Organizations can recruit both internally and externally. Regardless of the recruitment method, the organization must assess the effectiveness of the types of chosen recruitment methods. Once the recruitment process has been completed, the next step is to select the appropriate candidates for the organization. Typical selection processes include standardized interviews and, in some instances, employment tests that assess aptitude, attitude, honesty, and personality. These procesess must be legally defensible.

References

About Maxim Staffing Solutions. (2011). Available at: http://www.maximstaffing.com/aboutUs/index.aspx. Accessed December 9, 2011.

Arnold, D. (2011). Cognitive ability testing: White paper. Available at: http://www.wonderlic.com. Accessed May 29, 2011.

Byars, L. & Rues, L. (2006). Human Resource Management (8th ed.). New York, NY: McGraw-Hill/Irwin, pp. 111, 112, 132–133.

Dessler, G. (2012). Fundamentals of Human Resource Management. Upper Saddle River, NJ: Prentice Hall, pp. 100–102.

EEOC Selection Guidelines (2011). Available at: http://www.eeoc.gov/policy/docs/qanda_clarify_procedures.html. Accessed May 29, 2011.

ejobfairs.net (2011). What is an eJobFair? Available at: http://www.ejobfairs.net/index.php?page=whatis. Accessed January 11, 2011.

employtest.com (2011). Healthcare Aptitude Test. Available at: http://www.employtest.com/healthcare-aptitude-test-/. Accessed May 28, 2011.

Fried, B. & Fottler, M. (2008). Human Resources in Healthcare (3rd ed.). Chicago, IL: Health Administration Press, pp. 443–449.

Hitt, M., Miller, C. & Colella, A. (2006). Organizational Behavior: A Strategic Approach. Hoboken, NJ: Wiley, pp. 160–166.

Homula, M. (2005). The Great Eight: How to Identify, Select, and Hire Great Recruiters. Available at: http://www.ere.net/2005/10/11/the-great-eight-how-to-identify-select-and-hire-great-recruiters. Accessed January 11, 2011.

HON Code of Conduct (2011). Available at: http://hon.ch/HONcode/Patients/Conduct.html. Accessed January 10, 2011.

Increasing and Sustaining Racial/Ethnic Diversity in Healthcare Management (2010). Available at: http://www.ache.org/policy/minority.cfm. Accessed May 29, 2011.

Lievens, F., Coetsier, P., Fruyt, F. & De Maesseneer, J. (2002). Medical students’ personality characteristics and academic performance: A five-factor model perspective. Medical Education, 36:1050–1056.

Mathis, R. & Jackson, J. (2006). Human Resource Management (11th ed.). Mason, OH: Thomson/South-Western, pp. 192–223.

McLaughlin, C., O’Day, T. & Shorter, T. (2007). Can we use gender in our hiring decisions? The discrimination bona fide occupational qualification (BFOQ) applied to healthcare. Available at: http://www.gklaw.com/news.cfm?action=pub_details&publication_id=544. Accessed January 17, 2011.

Mondy, R. (2012). Human Resource Managemeent (12th ed.). Upper Saddle River, NJ: Prentice Hall, pp. 66–70.

Noe, R., Hollenbeck, J., Gerhart, B. & Wright, P. (2012a). Fundamentals of Human Resource Management (3rd ed). New York, NY: McGraw-Hill/Irwin, pp. 136–137.

Noe, R., Hollenbeck, J., Gerhart, B. & Wright, P., (2012b). Fundamentals of Human Resource Management (3rd ed). New York, NY: McGraw-Hill/Irwin, pp. 163–167.

Shermont, H. & Murphy, J. (2006). Shadowing: A winning recruitment tool. Nursing Management, November. Available at: http://www.nursingmanagement.com. Accessed November 1, 2010.

Source Yield (2011). Available at: http://www.shrm.org/Research/Articles/Articles/Pages/MetricoftheMonthSourceYield.aspx. Accessed December 10, 2011.

totaltesting.com (2011). Attitude and Aptitude (Identity) Tests. Available at: http://www.totaltesting.com/aptitude-attitude-tests.shtml. Accessed May 29, 2011.