Check the Records

Thorough screening of applicants isn't just a safety issue - it can also increase employee retention
By Nicole Benkert

When her phones started ringing off the hook after a National Public Radio (NPR) interview, Lori Post, PhD, was overwhelmed. "What Have I started here?" wondered Dr. Post, an assistant professor and violence researcher in Michigan State University's department of Family and Child Ecology. The project she's the lead principal investigator on - and why NPR, lawyers and others were calling her - is a program to improve nursing home background checks in the state.

Protecting Vulnerable Populations

While health care professionals are invested in protecting, caring for and treating vulnerable populations, concerns are brought to the forefront as tales of breeches of this trust surface in the national media.

"In the next 20 years we're going to have a greater shortage than there already is and there's going to be a larger population to be taken care of by a smaller working population," Dr. Post explained. Coupled with decreasing resources, this can lead to increased levels of violence.

In Michigan, different departments oversee different programs, with different screening requirements. Dr. Post's program looks to improve the screening process by incorporating standardization across the health care system. "It shouldn't matter which one of those agencies the [client] is placed in, they should still receive the same level of quality care."

"In order to fix the problem, we have to assess the problem," she said. Understanding the scope of abuse within different agencies is the first step. And while there's a worry that people will be implicated, Dr. Post said that most people think it's very important and that the response has been really positive. "They would like to provide the best workers for these vulnerable populations."

Applicants, Workers Expect Checks

The background check is a required part of the health care hiring process, but one that may not be fully understood by applicants. Beyond offering increased safety for vulnerable populations, the background check can create a better work environment for employees, help protect employers and increase retention.

At Harcum College in Bryn Mawr, PA, nursing students are told upfront that part of their application process includes a background check and that if they have a felony conviction they cannot sit for their boards. Their screening includes state and child abuse background checks, explained Marian Slater, PhD, RN, director of the nursing program. Students are informed that clinical sites or future employers may have different screening requirements, including fingerprint checks.

And while employers are all anxious to ensure adequate staffing levels, it's no excuse to forego performing background checks. "It often doesn't add any time to the hiring process," according to Barry Nadell, president and co-founder of InfoLink Screening Services, a nationwide employment screening provider based in Chatsworth, Calif. Some services are provided instantly while others may take from one to three days. "Due to the speed of results, three-day turnaround has not been an issue in health care hiring."

Becky Vizzone, human resources consultant for nursing at Children's Memorial Hospital, Chicago, agree that the time it takes for the background screening and reference checking isn't long. "It takes one of our support individuals maybe 10 minutes per hire." It adds up when the number of potential hires is considered, but it's manageable.

"Even before somebody gets that far, we do our reference checking which sometimes takes a considerable amount of time." Adding up the time to reach two professional references, she said it takes about two hours per candidate.

Protecting Employers and Employees

Prospective employees "seem to be aware that references are a required, much-needed part of the process," Vizzone explained. "I think that they understand it's a benefit to us as a reputable, ethical organization."

"On of the most important things about the background checks is that it not only protects patients, it protects students or a prospective employee," Dr. Slater said. Besides conducting screenings on students, more schools of nursing are screening their faculty as well. This protects the school and the clinical instructor. While complaints are fully investigated, the background check does offer protection. "Everybody is very conscious to any of these things regarding vulnerable populations," she added.

"This is a safety issue in terms of anyone whose health is entrusted to any health care worker," Dr. Slater stated. She admits that it's "conceivable" that somebody could slip through the cracks, "But it's very doubtful because it would all come under their criminal check."

Reducing Turnover Rates

Beyond protecting everybody in the care system, screening potential employees can also increase retention.

"Background checks reduce turnover by providing a more stable work force," Nadell stated.

"One of the problems is hiring unqualified people," Dr. Post explained. That leads to higher turnover. One aim of the Michigan program is to create strong evidence of the associated costs of employee turnover. This will help in preparing for the increasing shortages of qualified workers."

"In doing background checks on the candidates we attract, we are ultimately attracting really well-qualified candidates. And because we're attracting that caliber of candidate, when they join our team it helps with our retention because current employees see that we're really focusing on the quality of candidate we want to bring to them as team members."

"We're always looking to improve the process. There's always room to see what [screening] advances are coming down the pipeline," Vizzone concluded.

Nicole Benkert is an associate Web editor for ADVANCE.