The most effective way to choose a new employee who will fit in with the current team is to give the team a chance to interview the candidates and provide input, says Mindy Owen, RN, CRRN, CCM, principal owner of Phoenix Healthcare Associates in Coral Springs, FL, and senior consultant for the Center for Case Management.
“The people who will be the new case manager’s peers should be part of the hiring process. After all, they’re the ones who will work with and mentor the new person every day,” she says.
In her more than 20 years as a case management director, Peggy Rossi, BSN, MPA, CCM, ACMC-RN, CMAC, an independent case management consultant based in California, found it to be most effective when a two-person team interviewed the patients.
“It was usually me and a supervisor or manager. We used a predeveloped list of questions and alternated asking them. I always told the candidate in advance that we would be taking notes,” she says.
Following the interview with case management leadership, Rossi arranges for two to three peers to interview the candidates and report to her. “It’s critical for the staff who will work with the new person to have a chance to meet and evaluate them. After we got their feedback, the manager and I compared our ideas with the staff’s and made a decision about who would fit,” she says.
“A group approach to hiring works well,” says Tina Wiseman, MEd, chief administrative officer of Novia Solutions. “Ultimately, the director makes the decision but it’s more holistic if the peers and leadership the candidate will be working with have an opportunity to talk with the candidates and share their impressions with the director,” she says.
Wiseman recommends that a panel of three peers interview candidates and share their perceptions with the director. She suggests setting an hour aside for the interview and giving each staff member time to ask questions.
Develop three to five open-ended questions designed to give you an idea of the candidate’s personality and soft skill set, Wiseman says.
“There are some clinicians who are highly skilled and do an excellent job caring for patients from a technical standpoint, but they don’t have the empathy to be a good case manager,” she says.
The Novia team developed a tool that helps case management leadership assess the kind of characteristics that make a successful case manager. The tool includes specific questions that give employers an understanding of how a potential employee would act in certain situations.
For instance, the person conducting the interview might ask candidates to describe a time when they disagreed with a decision, how they handled it, and what happened, Wiseman says. Another question might ask the candidate to tell about encountering a negative attitude on the part of a fellow staff member, a patient, or a family member and give details on how he or she handled it.
Another way to probe for “soft skills” is to describe a situation that happened in the hospital, take out any details that might identify the participants, and ask the candidates how they would handle it.
Wiseman’s suggestions include a situation when the case manager must explain to family members that a patient will not function the same way after a stroke, or how to address the care team and physicians to identify and overcome the barriers that are preventing the discharge of a patient who no longer meets inpatient criteria.
“If you set up real-life examples and the candidate has to give you a story about how they will deal with the situation, you will get a sense of what they are like, whether they are going to be confrontational, or take a partnership approach,” she says.
Watch candidates’ body language when you interview them, Rossi says. “Watch their hands and feet. If they are uncomfortable, they will start squirming,” she says.
Wiseman and her team developed a set of questions for candidates, including how they might deal with a difficult physician, how they approach death and dying, or whether they are willing to make hard decisions about discharge. She’d ask the candidate to describe an example of a patient or family who was difficult to deal with and how he or she handled the situation.
“Just make sure you ask everyone you interview the same question,” she says. “I looked for the certified case managers. Certification means they’ve gone the extra mile and know what they are doing.”
When she interviewed nurses who were interested in becoming case managers, one of the first questions Rossi asked was, “Can you give up hands-on nursing care and handle the case management job?”
A significant number of nurses are moving into case management with no background in case management and no understanding of the process, Rossi says.
“Case management is where the rubber meets the road. Case managers focus on the business aspects of care, and it’s totally different from nursing. Nurses have to be able to take off their nursing hat and put on their case management hat,” she says.