Strategies for Rural Hospitals to Attract and Retain Staff

Strategies for Rural Hospitals to Attract and Retain Staff

Rural healthcare facilities often struggle to find and keep talent

Dec 13, 2018
Denise Bland, MHA

The demand for healthcare professionals is not limited to one area of the country, but rural areas are certainly beleaguered by the deficits. Many rural hospitals have an existing staff recruitment and retention problem. Several organizations have invested in virtual career fairs, built partnerships with medical schools and developed system wide marketing efforts to address the serious nature of the problem. The extensive geography of the issue emphasizes the market condition and suggests that staff recruitment and retention will continue to be an obstacle for the foreseeable future. 

It is crucial for rural hospitals facing recruitment and retention challenges to explore new approaches to recruitment and retention. The following are some creative tactics, many of which the author has personally applied to recruitment and retention:

  1. Rural upbringing: Some physicians and healthcare professionals desire a return to their community roots. It is advisable for hospitals to promote scholarship programs for students from the area, with obligations for return to area upon school completion.
  2. Behavioral interviewing: The author uses situational questions and asks candidates to give examples to answer questions, which helps to ensure the candidate is the right fit for the job. Physical task completion during interviews is advisable for laboratory roles to demonstrate competency.
  3. Networking: An often-undervalued resource is existing staff. Many excellent candidates originate from in-house employee recommendations. Also, do not underestimate the leverage of local societies and the power of relationship building at other hospitals in the vicinity. 
  4. Resume file: Keeping a resume file and a spreadsheet of candidate abilities, along with interview notes, is essential. You will often find that going back to these references helps to recover your original thoughts on whether the potential candidate is the right fit for the job.  
  5. Train your own/ tuition assistance: Online schooling and on-site internship opportunities can go a long way. They also enable employees to develop their careers, thereby encouraging employee retention. Show your employees that you care about their continued growth through a program for tuition assistance. Many companies get significantly discounted rates through community and state colleges. Consider a partnership with colleges and universities nearby and through distance learning. 
  6. Consider other skilled workers who can complete associated tasks: Look at the job description and make sure it is accurate regarding the qualifications for the position. Remind yourself of the reasons those qualifications exist. Are all the tasks necessary for an advanced skilled worker? Perhaps modifying the job description will allow the advanced skilled worker to handle additional volume, while a lab assistant assumes the responsibilities that were not essential to the job description. Such job task changes can have high impact. 
  7. Automate: Consider how software and instrumentation can help your existing staff to focus on higher quality tasks for patient care, rather than mindless repetitive tasks that are amenable to automation. 
  8. Social media: While you are not interested in the volume of candidates as much as quality, social media sites get significant traffic. Consider having managers advertise positions on their professional LinkedIn pages or other sites.
  9. Benefits: Companies like GE have started expanding benefits include student loan repayment. The longer staff members stay in their job, the more repayment they get on their loans. 
  10. Market your area: Entice candidates with the aspects of your community that are attractive. Allow the candidate to visit with their family and get to know the area. Ask existing employees to provide information on local schools, daycare, or other tips about the area. Considering presenting this information on a blog associated with your career page. 
  11. Focus on cost of living: Rural communities should point out the low cost of living in their area. The author has seen candidates turn down positions in bigger cities because added pay was just going toward daily survival. 
  12. Present an IT strategy: Have a comprehensive IT strategy to present to the candidate. The perception is that rural communities and small healthcare facilities are behind the times; you want to convince the candidate that your facility is technologically up-to-date. 
  13. Consider remote workers: With telehealth, it may not be necessary to have all employees in your community. This option would be especially appealing to candidates who value work/life balance. 
  14. Support continued learning: Budget cuts often mean that educational support for continuing education, travel to seminars or conferences, and registration fees to local conferences for existing staff are cut first. This is short sighted when considering employee retention. 
  15. HR strategy: Do not forget a valuable asset: the HR generalist. The HR generalist can make suggestions for low-interest home loans, relocation expenses, practice set-up costs, assistance with finding spousal employment, and assistance with locating daycare, among other incentives. 
  16. Competitive salary: A market salary adjustment should be a top consideration. Perform and market salary adjustment for existing staff and incoming candidates at least annually. 
  17. Onsite daycare: Consider what benefits onsite daycare would bring to all staff and ask employees for suggestions on how it would be maintained. If employees would like to creatively staff an onsite daycare, it is worth discussing. 
  18. Multiple job strategy: Consider that some employees may want opportunities for overtime and would like to fill other part-time positions. 
  19. Hire family members: It has been a strategy at some institutions to hire spouses with appropriate backgrounds. This package deal approach encourages employee retention. 
  20. Active recruiting: Keep a constant goal of attracting new employees. In some situations, you may consider slightly over staffing to keep a buffer on difficult to fill positions; it is likely that you needed additional full-time equivalents in key role areas anyways. Creative budget strategies and shared duties across job functions will help to achieve this goal. 



Denise Bland, MHA

Denise Bland has been in the field of histopathology for over 28 years. She works at a Boston hospital. Her days are spent striving to bridge the gap between laboratory protocols and best patient outcomes.