How to recruit caring and compassionate HCAs

Keywords: Values/Recruitment/
Healthcare assistants/Selection
Nursing Practice
Innovation
Recruitment
●This
article has been double-blind
peer reviewed
Value-based recruitment is a challenge in healthcare, but multiple mini-interviews,
which use a series of clinical scenarios, may offer a solution
How to recruit caring and
compassionate HCAs
In this article...
hy caring and compassionate values should be assessed at
W
interview
Use of multiple mini-interviews based on case scenarios to
measure values in potential healthcare assistants
Tips on implementing this approach
Author Karen Corder is clinical educator
and practice development coordinator/
lecturer practitioner; Suzanne Medows is
senior nurse practice development;
Andrea Morgan is staff development
officer, all at Newcastle upon Tyne
Hospitals Foundation Trust.
Abstract Corder K et al (2014) How to
recruit caring and compassionate HCAs.
Nursing Times; 110: 13, 20-22.
Heathcare organisations are faced with the
challenge of recruiting staff who have
caring and compassionate values so need
to ensure these can be identified at
interview. We piloted multiple miniinterviews as a possible solution to
recruiting healthcare assistants. This article
outlines how these were implemented
and highlights some of the pitfalls of using
this approach. Although the work has
not been evaluated formally we decided
to share our early experiences of using
this approach so others can learn from
our practice.
H
ow do you test candidates’
caring and compassionate
values in a job interview? This
is the challenge for many
healthcare organisations responding to
the Francis report (2013) and the focus on
caring and compassionate care highlighted by the 6Cs (Department of Health
and NHS Commissioning Board, 2012).
Responding positively to the 6Cs (DH
and NHS Commissioning Board, 2012) and
ahead of the publication of the Francis
report (2013) and the Cavendish review,
(2013) Newcastle upon Tyne Hospitals
Foundation Trust (NuTH) had explored
how we could improve quality and training
of our staff. The Francis and the Cavendish
reports both referred to a shortage of qualified staff and increased demands on them
within the ward environments. This has
resulted in increasing amounts of handson patient care being delivered by healthcare assistants (HCAs) so improving the
education and training provided to our
HCA workforce has become a focus area.
In October 2013 we implemented an
innovative “healthcare academy” designed
to provide all new HCAs with a two-week
induction that included education and
training in fundamental skills. We felt
that alongside this we needed to develop a
new approach to interviewing candidates
for HCA roles as we started to recruit to
the academy.
In November 2010, NuTH centralised
recruitment for HCAs. In June 2013, in
response to the chief nursing officer’s 6Cs
(DH and NHS Commissioning Board,
2012), the Francis report (2013) and in
anticipation of the Cavendish Review
(2013) we discussed how we could introduce values-based recruitment. The
Francis report had recommended that staff
recruited into the NHS should have their
values and behaviours tested.
We decided to adopt the idea of using
multiple mini-interviews (MMI), which
have been successfully used to recruit
medical students (Eva et al, 2012; 2009) and
appeared to meet our needs. We adopted
the idea of situational scenarios as part of
our interview process, based on some of
the key issues highlighted in the Francis
20 Nursing Times 26.03.14 / Vol 110 No 13 / www.nursingtimes.net
5 key
points
1
Staff recruited
into the NHS
should have their
values and
behaviours tested
Multiple
mini-interviews
have been
successfully used
to recruit medical
students
Structuring
interviews
around a series of
clinical scenarios
can be used to test
caring and
compassionate
values
Local patient
feedback and
complaints can be
used to inform
scenarios
Scenarios
should be
tested before they
are used
2
3
4
5
Caring and compassionate values need to
be identified in prospective healthcare staff
For a Nursing Times Learning unit
on equality and diversity, go to
www.nursingtimes.net/equality
Designing the process
It was agreed from the outset that we
should include clinical staff when
designing the process as we needed their
support in implementing the new interview assessment technique.
A small group was formed to develop
six clinical scenarios; this included a practice development coordinator and clinical
educators as well as clinical ward sisters. In
order to develop the scenarios we first had
to decide which attributes to focus on. To
do this we looked at patient feedback and
complaints received by the trust to identify key themes involving qualified members of staff and HCAs. We also used feedback from the Friends and Family Test.
In general, patient feedback demonstrated high levels of satisfaction and
where this was not the case, poor communication was highlighted as an issue. The
group also used the trust’s core professional and leadership behaviours (PLB) as a
benchmark (NuTH, 2013). Aligned to the
NHS Constitution (DH, 2013) and the
trust’s vision and values, the core behaviours require that staff are “Putting
patients at the heart of activity, listening
and responding to their needs compassionately and demonstrating respect for
their opinions and wishes” (NuTH, 2013).
Using the PLBs as a benchmark, along
with knowledge gained from patient feedback and key contemporary issues such as
the 6Cs (DH and NHS Commissioning
Board, 2012), helped our group to focus on
developing scenarios to target these
important areas for recruitment. Some of
the key attributes were:
» Caring/compassion;
» Ability to follow instructions;
» Ability to prioritise workload;
» Ability to recognise when behaviours
needed to be challenged and courage to
challenge them;
» Good communication skills.
Examples of scenarios are outlined in
Box 1.
Testing out the scenarios
When all six scenarios were developed we
had to consider how useful they would be
in the recruitment process. The initial
ideas were developed as we tested them on
other members of the practice development team and non-clinical staff. Testing
them on clinical staff helped us to assess
exactly what issues each scenario was
addressing. It was equally valuable to test
them on non-clinical staff with no background in clinical care. This highlighted
the importance of using plain language.
For example, we changed the term “commode” to “portable toilet” as a result of
feedback from a work experience student.
Although developed by staff who
understood the underlying theme, one of
the scenarios was modified when it was
used on the first assessment day as it
caused some unexpected confusion. Box 2
shows the original scenario question
relating to smoking cessation. Staff were
provided with model answers to assist
them but candidates were picking up on
issues of patient choice around cigarette
smoking and health promotion rather
than discussing the attitude of the staff
involved.
Examples of this included:
“Well it’s not for the nurse to judge the
patient for smoking, it’s their choice.”
“The nurse should ask the patient if he
wants help to stop smoking and so she
should give him some nicotine products.”
Both are good answers, but neither
addressed the intended issue of raising
concerns.
Candidates were not penalised and interviewers who identified those confused by
the question steered them in the right direction. In an effort to be fair to all candidates
the scenario remained the same until
the end of the interviews that day and was
updated before further interview assessment days.
Box 2 shows the updated version of the
scenario.
Selecting interview days
Candidates who met the essential criteria
in the person specification were shortlisted. Those with an NVQ level 2 in an
appropriate (health-related) subject or
equivalent qualification/experience, as
well as good numeracy and literacy skills,
were contacted by letter by the human
resources department.
Instead of being issued with a date and
time for interview, candidates were asked
to telephone and “self-select” an interview
slot. This allowed them to opt for the most
convenient time for them, which we hoped
would reduce the number of candidates
who do not attend on the day. It also meant
that candidates who had secured employment elsewhere or indeed changed their
mind about the vacancy did not receive an
appointment unnecessarily. This in turn
reduced the time wasted by staff waiting
for candidates who failed to attend for
their interview.
Venue and timing
Once the scenarios were finalised, the
venue and timing had to be addressed as
these were vital for the delivery of the
assessment process. We needed space to
welcome candidates, a waiting area, and
rooms that allowed easy movement
between scenarios yet avoided candidates
overhearing the responses of others being
interviewed.
Clinical staff who had volunteered to
assist in the scenario stations were
briefed on the day, “walked through” the
Box 1. Sample scenarios
Scenario 1. Privacy and dignity
You are a healthcare assistant (HCA) on
a ward working as part of the blue team.
A relative of a patient being cared for by
the red team informs you that their loved
one is lying naked and exposed on the
bed and asks you for help. Please discuss
what you would do
● Scenario 1 aims to identify candidates’
basic reaction to a patient’s privacy and
dignity, regardless of which team they
are working with
Scenario2. Handwashing
You are an HCA in a clinical area. Using
the written instructions provided please
wash your hands
● Scenario 2 is used to establish whether
candidates can follow a set of simple
instructions. Correct handwashing
technique is not the main focus of this
scenario; that can be corrected when
successful candidates undertake their
training at the healthcare academy
before working in the clinical area
www.nursingtimes.net / Vol 110 No 13 / Nursing Times 26.03.14 21
SPL
report (2013) including dignity in care and
raising concerns.
The scenarios and layout for the interview days mimicked the observed structured clinical examinations (OSCEs) used
to assess medical students and nurses in
clinical practice. This involved a circuit of
six stations where candidates were presented with a scenario and then “tested” by
two impartial clinical staff. Each station
has different staff testing the candidates,
rather than one examiner following a candidate throughout the whole process. We
anticipated this style of testing would help
triangulate views of the candidates and
rule out some of the subjectivity involved
in the traditional interview process.
Nursing Practice
Innovation
stations and given an opportunity to ask
questions.
A timetable was designed to allow candidates to move through the assessment
process in groups of six, rotating round
each scenario station in a clockwise
manner. The candidates were given one
minute to read the scenario then two
minutes to discuss it with two members of
clinical staff. A timekeeper ensured that
candidates were instructed verbally to
begin their reading time, discuss the issue
with the clinical staff at that station and
then rotate to the next station.
Scoring the candidates
Candidates were scored in each scenario
from zero to three depending on their
answer. The staff based in each station
remained there for the course of the interviews to make the process more objective
and fair for each candidate.
Scores from each scenario were then collated into a grid allowing the staff involved
in the interviews to gain a more rounded
picture of each candidate’s values and
traits. Successful candidates were those
who scored an average of 60% or higher.
Interestingly, clinical staff who assisted in
the scenarios were at times surprised by the
scores from particular candidates:
“I’m surprised to see that particular
candidate scored poorly in most stations... I
thought they were very articulate. I scored
them a three for my station and could see
how they would fit into my team... I guess it
[scoring grid] shows that they are not the
ideal candidate after all.”
Measuring effectiveness
The recruitment process is receiving positive feedback from candidates and staff:
“I was terrified when I realised I was not
Box 2. Evaluating
effectiveness of
scenarios
raising concerns
Original scenario
You are a healthcare assistant (HCA)
helping a qualified staff nurse to
provide personal care to a breathless
patient. The patient asks if he can go
outside for a cigarette when he is
dressed. The staff nurse responds
abruptly to the patient: “No you cannot,
that’s what brought you here in the first
place.”
Please discuss your thoughts
Revised scenario
You are a healthcare assistant (HCA)
helping a qualified staff nurse to
provide personal care to a patient.
While delivering the care the staff nurse
is rude and abrupt in her manner
towards the patient.
Please discuss your thoughts
just going to be talking to someone faceto-face... I just wanted to get it over and
done with, but I have enjoyed it and it has
helped me to see the kind of situations I
might find myself in, and how I will cope
if I do.”
“I have calmed down since I spoke face-toface with the members of staff for the first
interview questions... I really like this
system... it gives us more than one chance
to shine.”
Although initially apprehensive of the
new recruitment process, clinical staff
Love Being a
Student Nurse?
#loveSNT you
give students
easy access to
relevant material that
not only helps us pass
our studies but makes us
great nurses. @RachieRuu
#loveSNT love you
because you have
given us the opportunity
to air our important views
and share hints and tips
with each other. @LDstudentnurse
Follow us:
have come to trust it. This trust helps to
reassure any ward sisters who have been
unable to interview candidates themselves
to feel confident that those who have
completed the selection process are of a
high calibre.
Future plans
We need to be confident that the MMI
approach to interviews does enable us to
select in a more consistent manner than
traditional interview. We plan to compare
the number of HCAs employed and retention rates with those in previous years to
measure the impact.
Qualitative feedback from ward sisters
and the clinical staff involved in the interview process will also be sought. This will
include feedback on their perception of the
values and behaviours of staff recruited
through this process. NT
References
Cavendish C (2013) The Cavendish Review: an
Independent Review into Healthcare Assistants
and Support Workers in the NHS and Social Care
Settings. tinyurl.com/cav-review-2013
Department of Health (2013) The NHS Constitution.
London: DH. tinyurl.com/DH-NHS-constitution13
Department of Health and NHS Commissioning
Board (2012) Developing the Culture of
Compassionate Care: Creating a New Vision for
Nurses, Midwives and Care-givers. London: DH.
tinyurl.com/DH-6C-2012
Eva KW et al (2012) Association between a
medical school admission process using the
multiple mini-interview and national licensing
examination scores. JAMA; 308: 21, 2223-2340.
Eva KW et al (2009) Predictive validity of the
multiple mini-interview for selecting medical
trainees. Medical Education; 43: 767–775.
Francis R (2013) Report of the Mid Staffordshire
NHS Foundation Trust Public Inquiry. London:
Stationery Office. tinyurl.com/HMSO-Francis2
Newcastle upon Tyne Hospitals Foundation
Trust (2013) Professional and Leadership
Behaviours: Core Behaviours Expected of all Staff
to Put Patients at the Heart of Everything we do
(updated). tinyurl.com/NuTH-values
#loveSNT
because you
give us all kinds
of help and support!
You’re there if we need
you or feel that we can't
talk to uni people! :)
@Hazzaa_haribo
Love Student
Nursing Times
Join Student Nursing Times for just £8.50 a quarter. subscribe.nursingtimes.net/SNT-STJZ
22 Nursing Times 26.03.14 / Vol 110 No 13 / www.nursingtimes.net

Download Report