Welcome to the Lean, Just-In-Time Blog and Resources Page

Our published "Best Practice" recruitment tools, tips and thoughts are stored here. Each blog is keyword searchable (use the search function in the top right hand corner of the page). You can utilize these resources to immediately impact and improve recruitment performance! Our clients use these materials to guide continuous improvement learning sessions and to assist with the "behavior modification" process.

Role of Healthcare Recruitment in Addressing the Nursing Shortage

July 29th, 2015

The United States has the largest nursing workforce in the world with nearly 3.5 million nursing professionals. It’s hard to believe we’re expecting a shortage of 193,000 nurses over the next five years. Based on the demographics of the current workforce, the size of graduating nursing classes, and the direction of nurses’ careers, experts project the active supply of nurses will increase steadily from 3.5 million to 3.95 million by 2020. Despite this substantial growth in supply, researchers at Georgetown University’s Center on Education and the Workforce predict it still falls short of demand — estimated to be 4.14 million by 2020.

Unfortunately, we’ve been in the midst of a nursing shortage for quite some time, and it’s a staffing issue that extends beyond a matter of inconvenience. It’s dangerous for everyone involved — adding unnecessary stress to an already stressful occupation.

Additionally, the healthcare industry continues to evolve due to government regulations, shifts in care delivery models, and the expansion to new business verticals to address the needs of the aging population. In the past two years we’ve seen an influx of 32 million new patients to the national healthcare system with the passing of the Affordable Care Act. We’ve seen “Baby Boomers” begin to slowly but surely take advantage of healthcare services. Based on these factors alone, it’s likely the labor shortages are going to worsen until steps are taken to improve the situation.

This widespread shortage has reached a level so disconcerting that The New York Times recently ran an eye opening op-ed piece about our dire need for a solution to the all too common, dangerously imbalanced, nurse-to-patient ratio in hospitals nationwide. However, what the article failed to address, and what many people fail to realize regarding this issue, is it’s not only nurses who are struggling (and often failing) to keep up. But rather, this problem and what I believe to be its solution starts with recruitment.

Similar to nurses, healthcare recruitment and human resource professionals are more overworked and understaffed than ever before. Hospitals and health systems are growing and trying to hire like crazy, while their recruitment teams are scrambling to fill the ever-growing list of open positions (very often without the help of additional recruiters). While two years ago many recruiters were responsible for managing 40-50 requisitions, they’re now often required to manage 100 or more. Unrealistic requisition loads coupled with a dated and inefficient process have exacerbated the problem.

So, what can be done to assist overwhelmed recruiters so we can ultimately get more nurses hired, and hired faster? Well, first of all, add more recruiters to your team. There’s simply no way around it. Without adding recruiters to your team to help lower the number of open positions for which each recruiter is responsible, your organization runs the risk of promoting quantity over quality. Holding one recruiter responsible for managing 100+ positions is unrealistic, chaotic, and can lead to filling jobs fast, rather than filling jobs with the best candidates. Secondly, implement lean recruiting techniques to guide your organization’s recruitment processes. With lean principles in place, recruiters can focus on hiring the right person for the right job.

In a recent HR Pulse article titled, “Lean Recruiting Techniques Deliver Abundant Benefits”, my colleague David Szary discusses the processes and benefits of lean recruiting (e.g., using lean principles, Six Sigma, and/or Theory of Constraints to develop a more efficient recruiting process) as applied to healthcare organizations. In his words, “By applying these methodologies, you can look at how to reduce waste, wait time and errors, ultimately improving the customer experience, reducing costs and increasing revenue.” Lean recruiting is also defined by one HR leader Carla Kennedy MBA, Human Resources Manager at Chicago’s Rush University Medical Center, as “…continuously trying to remove activities that don’t provide value, and identifying waste and delay in our process so we can focus on providing more value-added activities.” Essentially, lean recruiting is about simplifying the process while simultaneously cutting cost and providing organizations with improved performance company-wide, and it’s been proven to work. In Rush’s case alone, as is highlighted in the HR Pulse article mentioned above, they have cut 20 days off their time-to-fill (from 60 to 40), as well as reduced their advertising costs by 41 percent.

Change is never easy, and gradual change takes patience, but it’s becoming painfully clear that change is needed in traditional healthcare recruitment process to meet the demands of the future healthcare environment. While there is no quick fix to our nationwide nursing shortage, lean recruiting is certainly a step in the right direction.

While there is no quick fix to our nationwide nursing shortage, lean recruiting is a great way to start remedying this problem, and Lean Human Capital can help your organization get started. In the past six years alone, Lean Human Capital has studied the recruitment processes, best practices, and performance metrics of 350+ hospitals, and our team has worked with more than 3,000 respected organizations throughout the world. As a result, Lean Human Capital can provide your organization with healthcare recruitment tools that have not only proven successful in facilities such as Chicago’s Rush University Medical Center, they’re legitimately backed by years of collective data and best practices.

Brian Brazda

Recruiters: The Unfortunate Honor of Being a Member of the 100+ Club – Part II

July 21st, 2015

So if you are a member of the 100+ club (Read BLOG from last week), it’s not a good situation to be in for sure.

And no matter how good you are, how LEAN or creative you get . . . you will not be able to provide a quality recruitment service to meet hiring demand (if you can – CALL me ASAP since I have never seen it!).

You need to justify why you need FTEs and seek approval from your executive leaders (COO/CFO).

A starting point is to benchmark against industry peers.

We have been providing organizations staff productivity and requisition per recruiter benchmarks for years. These will allow you to frame a business case by showing leadership that you are managing 30, 40, 100% more openings, per resource, than your competition.

These simple benchmarking metrics will help your business case but . . . probably not by itself justify resources.

A more advanced methodology to quantify FTEs is using our demand-based staffing optimization methodology. We have been using a production/supply chain methodology for years (think Materials Release Planning – MRP – for you Lean junkies) to quantify FTE resources based on hiring demand. If you are interested in this – CHECK OUT an article I wrote on this subject.

Most importantly – you need to quantify what the investment in FTE resources will do for the organization. Three easy return on investment arguments include:

  1. Reduction in cost associated with turnover.
  2. Reduction in cost of vacancy (agency & OT spend).
  3. Reduction in time wasted in an inefficient process.

I provided some details to all three of these ideas in a blog I wrote last year.

If you want resources, you need to justify why and what they will do for the organization. I am proud to say that this year alone, we have helped 5 more organizations secure more resources using the ideas presented in this blog!

Good luck 100+ club members. If you need help – give us a call!

David Szary

Recruiters: The Unfortunate Honor of Being a Member of the 100+ Club – Part I

July 15th, 2015

It happened so quickly. Seems like overnight. Out of nowhere.

Since the start of the year, I have not experienced such a dramatic increase in hiring volume within an industry since the tech boom of the late 90’s.

While the structural supply/demand labor issues within healthcare is well documented, it really hasn’t fully reared its ugly head until this year.

And the Perfect Storm most predicted is upon us now.

Key catalysts of the storm:

  1. Most recruitment organizations reduced FTE resources during the last 6 years.
  2. Hiring volume (especially for specialty, experienced professions) is up.
  3. Retirement of healthcare leadership, nursing and physicians is happening.
  4. Consumer confidence is the highest it has been since 2007.

The reality – Fewer resources faced with filling more positions!

This has created a new community of recruiters who have the unfortunate honor of being a member of the 100+ club. Those are recruiters that on average are managing over 100 open positions at a time.

Now over the years, I have found it is not uncommon to find recruiters managing 50, 70, 80 open positions. But now, I am finding entire teams averaging 100+!  One team we are working with is averaging 130!

In future BLOGs – I will discuss how you can justify FTE resources to meet hiring demand.

If you have this unfortunate honor of being a member of this community and need help NOW – please
reach out to me.
We have helped organizations justify new FTE resources using ROI-based proposals that CFO’s understand and appreciate.

David Szary

One Easy Way To Reduce TTF By 25% Or More

July 8th, 2015

LEAN Interview Scheduling

In last week’s blog, I shared why I thought overall average Time to Fill is somewhat of a meaningless metric.

With that said, I would still track it (since many will ask for it) BUT be able to articulate the story behind this metric.

More importantly, how can you reduce TTF given the current state of the labor market and increased demand for services.

While nothing is ever ‘easy’, I want to share a practical way to reduce TTF by up 25% or more over the next quarter – something we call LEAN Interview Scheduling.

Over the last 17 years, we have performed hundreds of Value Stream Mapping sessions on the hiring process.  We have found that of the total time it takes to fill a position, 50% or more of the time is waiting for interviews to be set up.  In a typical hiring process: A recruiter routes candidates for consideration . . . . then a manager reviews the candidates credential . . . .then they decide who they want to interview . . . then someone (recruiter or admin) contacts candidate . . . then they schedule interview!  So much WAIT time!  And if the candidate needs to come back for a second or third interview . . . add on days/weeks to your TTF.

Here are some LEAN Interviewing tactics to reduce TTF:

  1. For your high volume positions, pre-schedule Interview ‘Blitz’ days for the entire year:
    1. Get with the department, identify hiring demand (pretty easy – usually turnover rate x current headcount = demand for year).  This will tell you how many interviews you will need to conduct monthly to meet hiring demand.
    2. Identify a day (or days) that you will conduct interviews onsite each month. Plan out this schedule for the entire year.
    3. Develop a process with hiring leaders to facilitate multiple interviews over a 3-4 hour period of time.
    4. As you source and screen candidates, you can immediately set the candidates up for an interview on that day without having to seek hiring manager approval.
  2. For exempt level positions, ask for the managers approval to allow you to schedule interviews on their calendar when you identify a promising candidate. This will eliminate the back and forth associated with routing candidates for review, etc.
  3. If the hiring manager won’t go for option 2, then set up a weekly status call (or bi-weekly) to review candidates to interview. This will eliminate the time wasted routing and waiting for feedback. You can meet with hiring manager, review slate and slot interviews all within a ½ hour of time.

Now – I know these three options won’t work with every manager or every scenario BUT . . . If it works with 50% of your managers – - you will see an immediate reduction in TTF.

David Szary

What Is The Industry Average TTF

July 1st, 2015

And Why It Is Meaningless!

We just finished our annual Healthcare Recruitment Metrics Benchmark Study.  While demand for talent has skyrocketed over the last 6 months, our benchmarks year over year remained relatively consistent (FYI – I expect that to change this coming year).

So what was the Average TTF this year? 49 days (last year it was 48).

Average Time to Start? 67 days (66 last year).

That is across all job families for respected health systems around the country.

So why do I believe this metric is somewhat meaningless?

Because it doesn’t truly reflect what is going on within the organization (I wrote about this last year).

While average TTF is 49 days, 74% of all positions are being filled in 25 days! While the other 26% take 115 days to fill.

Think about that. For 3 out of every 4 hires, a typical recruitment organization is very fast.  While the other 1 out of 4 times, it takes close to 4 months to fill a position!

These data points have been very consistent since we started tracking this 5 years ago and is one of the key underlining reasons why hiring manager perceive that positions aren’t filed “fast enough.”

The reality is . . . 76% of the time – we do it very fast. It is the other 24% that form their perceptions related to “speed.”

Now to be fair, many of these positions have a high cost of vacancy and are critical to the organization. So they should be concerned about speed. I will discuss HOW to reduce TTF for these positions in a future blog.

But to say that recruitment just doesn’t do things fast enough usually is an inaccurate, blanketed statement.

While I know most organizations want to track overall average TTF and TTS, I would encourage you to start isolating how well you perform across all job families and ensure managers understand the true story with respect to Speed.

If you are interested in our Benchmark study, and how you can use this data to manage client expectations and perceptions – let me know.  We can be your advocate for change in your organization!

David Szary

What Candidates Say About Recruiters

June 24th, 2015

And the impact it has on your organization

If you have recruited for any length of time, you have heard countless stories of crazy candidate experiences. From your serial applicants to phone stalkers . . . we capture our fair set of stories to share at happy hour on a Friday night.

On the flip side, we have been analyzing the candidate experience utilizing our validated Voice of the Customer Assessments. And as you can imagine, there are plenty of things recruiters do that drive candidates crazy.

LinkedIn had a great post on this recently called

Five Things Recruiters do that Drive Candidates Crazy

In summary – I am sure you would not be too surprised of what made the Top Five:

  1. Recruiters don’t keep candidates up-to-date.
  2. The hiring process is sloooooooow.
  3. They don’t give straight answers.
  4. They reach out despite knowing nothing about the person.
  5. They don’t know the job – at all.

Through our research, we have found that an applicant’s experience directly effects their intentions moving forward.

Some interesting statistics from a recent survey:

  • Of all the applicants that did not get hired, 21% said they had a positive experience while 45% said they had a negative experience.
  • Of the individuals that had a positive experience:
    • 80% were likely to speak to others about their experience.
    • 97% were willing to apply in the future.
    • 95% were likely to refer someone to the organization.
    • 42% were likely to change their consumer habits related to the organization (i.e. use them and/or buy there products or services).

The power a positive applicant experience has on recruitment and the organization is very, very important.

I encourage you to self reflect on what your candidates would say about you!

If you are interested in our Validated Voice of the Customer Assessment Services – let me know.

David Szary

What Is Your Recruiter Passion Statement?

June 17th, 2015

Why do you do what you do?

I just started 3 Private Recruiter Academy Training Programs  last week. And in Module 1 of the program, we ask each student what their passion is for recruitment.  Why do they do what they do? Why did they choose the recruitment profession?

Of course, with any profession, there are things that recruiters don’t like about their job. That‘s normal.

But if you don’t have some type of passion for what you do for a living, you probably are not going to excel at it long term (no matter how much talent you have for it!).

There was a great post the other day on this subject.

Check it out!

I would encourage each and every one of you to write down your Passion Statement and put it somewhere that is visible in your work space.

Let’s face it – day in and day out, our profession is very challenging.  With that said, it is so rewarding to connect someone with the right opportunity they are truly grateful for (and a hiring manager is grateful for as well).

Have a great day.

David Szary

Recruiters – Two Keys To Sleeping Well At Night

June 9th, 2015

Are You Doing Them?

Like most of you, I am busier than ever!

As I go through the day, my To-Do list grows and grows. It’s not uncommon for my emails to swell by a hundred or more in a short period of time.

With that said, I am in more control of my schedule, my To-Do list and my inbox than ever before! And most importantly – less stressed!

What are my keys to success?

  1. I plan my next Perfect Day BEFORE I end the day.
    1. I have a time-based schedule built that plans every day down to the half hour.
    2. I am trying to get better at planning time for CIEs (calls, interruptions and emails).
    3. I print out my schedule and put it on my desk turning the page on one day and feeling ready for the next.
  2. I end each day with no more than 10 emails in my inbox. Shutting down my computer with less than 1 page of emails in my inbox is therapeutic! I have diligently practiced the techniques we preach in Module 2 of The Recruiter Academy relative to managing an email inbox and the reward has been more productive, stress free days in the office.  Don’t think it’s possible?  At the end of Module 2, I challenge recruiters to the Perfect Day, Perfect Week℠ 21 day challenge.  Without fail, over 80% of the recruiters successfully complete the challenge!

I challenge you to a 5 day Perfect Week, Perfect Day℠ to manage your inbox to 10 emails or less when you the leave the office.  If you’re passionate about regaining your sanity . . . accept the challenge, and you’ll see results.  Guaranteed!

If you feel stressed during the workday and have trouble sleeping at night because your mind is racing about all the things you need to get done tomorrow.

Try to plan for the next day before you leave the office and get your inbox to one page of emails before you shut down your computer at night.

It sure has helped me!


David Szary

Establishing A Starbucks Fund To Recruit Top Talent

June 3rd, 2015

Could be your best investment ever to find top talent


In last week’s Blog,  I talked about leveraging your Centers of Influence by tapping into your reference database. This provides you access to thousands of quality professionals for FREE!

Another often under-utilized Center of Influence is your New Hires.

These individuals are arguably the best referral sources. Why?

  • They are excited (should be) about their new position.
  • They have recently left another position.
  • Their network of former co-workers is “fresh”. They can probably connect with them quickly and have a good understanding of who is top talent and who is not.

Now referral sourcing from new hires obviously is not new. Almost everyone has some type of Employee Referral Program to encourage them to send referrals.

But from my experience, the key to harvesting referrals is more technique versus task.

Critical to your success is your ability to build rapport with your referral source and artfully use conversational investigative questions  to harvest referrals.

To that end, I can’t think of a better use of time and money than to buy your new hires a cup of coffee and Mindstorm about people they know for the positions you have.

The hour conversation and cost of a cup of coffee could lead to an exponential number of quality referrals.

Now I know you can’t sit down for a cup of coffee with each and every hire (or logistics might not be in your favor).

But individuals you just hired for difficult to fill positions . . . this to me is a MUST J.


David Szary

Passive Candidate Database You Build For Free

May 27th, 2015

And Full Of Top Talent

In our desperate search to find top talent for difficult to fill positions, we often overlook the obvious sources.

In our RACR Module 6,  we discuss Leveraging our Centers of Influence (employees, hiring managers, applicants, new hires, candidates, etc.) to identify and network with talented, mostly passive professionals.

We discuss (among other ideas):


One source that I continue to find under utilized is applicant references.

Most organizations ask for 3-5 references from each applicant. If you have 10,000 candidates apply – that is 30-50k of professionals to network with and/or recruit! 100k applicants = 300k references!

If you use a validated reference checking tool like Reference Assessment  you get to tap into a database of references that have already checked a box stating, “I wouldn’t mind someone contacting me about job opportunities at your organization.”  How great is that?

When seeking top talent, don’t forget to leverage your Centers of Influence!

Happy Hunting.

David Szary