1. JANUARY/FEBRUARY2015
36
www.nhia.org/CE_Infusion
Continuing Education
BUILDING A DYNASTYTalent Management Strategies for Efficient and Effective Staffing
By Todd Youse, Brad Barrell, and Jeannie Counce
PHARMACISTS AND PHARMACY TECHNICIANS
This INFUSION article is cosponsored by Educational Review Systems (ERS), which is accredited by the Accredi-
tationCouncilforPharmacyEducation(ACPE)asaproviderofcontinuingpharmacyeducation.ERShasassigned
1.0 contact hours (0.1 CEU) of continuing education credit to this article. Eligibility to receive continuing educa-
tion credit for this article begins January 30, 2015 and expires January 30, 2018. The universal activity numbers
for this program are 0761-9999-15-026-H04-P and 0761-9999-15-026-H04-T. Activity Type: Knowledge-Based.
NURSES
Educational Review Systems is an approved provider of continuing nursing education by the Alabama State
Nurses Association (ASNA), an accredited approver of continuing nursing education by the American Nurses
Credentialing Center, Commission on Accreditation. Program #05-115-15-004. Educational Review Systems is
also approved for nursing continuing education by the state of California, the state of Florida, and the District
of Columbia. This program is approved for 1.0 hours of continuing nursing education. Eligibility to receive
continuing education credit for this article begins January 30, 2015 and expires January 30, 2018.
DIETITIANS
Educational Review Systems (Provider number ED002) is a Continuing Professional Education (CPE) Accred-
ited Provider with the Commission on Dietetic Registration (CDR). Registered dietitians (RDs) and dietetic
technicians, registered (DTRs) will receive 1.0 hour or 0.1 continuing professional education unit (CPEU) for
completion of this program/material. Eligibility to receive continuing education credit for this article begins
January 30, 2015 and expires January 30, 2018.
Dietitian Knowledge Level: 2
Dietitian Learning Codes:
1070 Leadership, critical and strategic thinking
7010 Business plan development
7090 Human resources management, labor relations
7190 Supervision, crisis management
7180 Strategic planning
7200 Team building
CPE
Accredited
Provider
Continuing education credit is free to NHIA members, and available to non-members for a processing fee. To apply for
nursing or pharmacy continuing education, go to www.nhia.org/CE_Infusion and follow the online instructions.

2. JANUARY/FEBRUARY2015
37
www.nhia.org/CE_Infusion
Continuing Education
L
ike health care, staffing needs can be acute or
chronic. Most organizations have experienced the
scramble to fill an unexpected void after the sud-
den departure of a key team member. Without a lot of
time to plan for a replacement, filling the void and quick-
ly onboarding the new recruit are the immediate focus,
often diverting attention and postponing progress until
the team regains equilibrium. It happens, but some orga-
nizations seem to constantly live in this cycle. The result
is a team that lacks cohesiveness, trust, and organization-
al memory (not to mention the detrimental financial and
human resource costs related to reduced productivity).
Members of these teams are less engaged and more
susceptible to turnover. These organizations, as well as
those that are chronically understaffed, are less produc-
tive, less innovative and not as likely to withstand stress.
There are also healthy organizations, where staffing is
an ongoing, dynamic process. Teambuilding is part of
the organizational culture; the need for new positions
evolves along with the implementation of the strategic
plan; turnover is low; and departures and succession
planning happen proactively with fewer disruptions.
These organizations take a creative approach to staffing
and teambuilding. Such “talent management” strate-
gies may or may not exist in an officially codified docu-
ment, but leaders of such healthy organizations are at-
tuned to their staffing needs and the members of their
teams. At the same time, they build organizations that
attract and foster talent.
Talent management has a significant impact on an
organization’s productivity, and therefore, profitability.
Perhaps for the simple fact that turnover comes with
Approval as a provider refers to recognition of educational activities only and does not imply Accreditation Council for Pharmacy
Education, ERS, or ANCC Commission on Accreditation, approval or endorsement of any product. This Continuing Education
Activity is not underwritten or supported by any commercial interests.
This continuing education article is intended for pharmacists, pharmacy technicians, nurses, and other alternate-site infusion
professionals.
In order to receive credit for this program activity, participants must complete the online post-test and subsequent evaluation
questions available at www.nhia.org/CE_Infusion. Participants are allowed two attempts to receive a minimum passing score
of 70%.
EDUCATIONAL LEARNING OBJECTIVES:
1. List the five steps involved in workforce planning
2. Describe the differences between “build” and “buy” talent management strategies
3. Name two factors that contribute to the development of strong foundations for teams
AUTHOR BIOS:
Todd Youse is Director of Recruiting & Client Services at the Remedy Group in Portland, Oregon. He has been with The Remedy
Group since February 2010 and specializes in helping home infusion and specialty pharmacies hire and retain the very best talent
on the market. He takes a consultative approach with his clients and works with them to create customized hiring strategies
that work. Having been a small business owner himself, Youse has a keen understanding of what a client needs and how to find
it. His focus in college was Business Administration with an emphasis on Entrepreneurship and Innovation.
Brad Barrell is the Acting Vice President of Human Resources for the North America region at CHEP USA, a Brambles Company.
In this role Barrell reports to the President, CHEP North America and leads all Human Resources activities supporting a diverse
employee population of over 5,000 employees. He started his career as a technical recruiter and staffing manager at Aerotek, a
national placement agency. He then transitioned into Human Resources when joining CHEP in 1999. Since his time with CHEP,
he has held a variety of roles focusing on strategic talent acquisition, employee relations, compensation and benefits, change
management, organizational and employee development, policy and procedure development, performance management and
competency development, and employment law. Barrell graduated from Radford University with a bachelor’s degree in Sociol-
ogy in 1994. He can also juggle!
Jeannie Counce is the Editor-in-Chief of INFUSION magazine, the bimonthly journal of the National Home Infusion Association
(NHIA). She has more than 15 years experience as a health care writer and editor, covering topics ranging from outpatient phar-
macy and nursing to reimbursement, regulations, and other business issues. A 1989 graduate of James Madison University, she
has been involved in association communications and publishing for nearly 25 years.
AUTHOR DISCLOSURE STATEMENT:
The authors declare no conflicts of interest or financial interest in any product or service mentioned in this program, including
grants, employment, gifts, stock holdings, and honoraria.
Questions or comments regarding this article should be directed to: Jeannie.Counce@NHIA.org

3. JANUARY/FEBRUARY2015
38
www.nhia.org/CE_Infusion
Continuing Education
many, exorbitant costs. The U.S. Department of Labor
estimates that it costs one-third of a new hire’s salary to
replace the previous employee.1
Specific industries and
labor markets can drive this figure as high as 200% of an-
nual compensation, according to the American Manage-
ment Association.2
Low productivity, absenteeism, and
potentially corrosive morale are among the many other
less-quantifiable drawbacks of having a low-performing
employee in place.
There are two sides to the talent management coin:
“build” and “buy.” Building focuses on what an organi-
zation already has—the internal aspects of developing
and maintaining a robust team with an eye toward fu-
ture. Buying is when an organization reaches outside
its own talent pool for new hires to augment its team
as it moves forward. Successful organizations in any in-
dustry must devise both “build” and “buy” strategies to
effectively manage their human capital and compete in
an ever-evolving marketplace. Following are some con-
siderations for home and specialty infusion businesses
looking to make the best of their human capital.
Building Talent from Within
As organizations evolve and grow, the resources re-
quired to meet new goals and objectives will change.
The pipeline of skills and expertise needed to execute
new product and service lines should be developed as
strategically as the company’s offerings themselves. To
anticipate and prepare for these dynamics, successful
organizations engage in workforce planning, a system-
atic process for identifying and addressing the gaps be-
tween today and a point in the future.
Workforce planning consists of five basic steps (see
Exhibit 1).3
Essentially, the organization analyzes its
workforce against its strategic plan and business perfor-
mance plans to sketch out its short-term and long-term
needs, focusing on specific positions, skills, numbers,
and locations. Comparing this list to an inventory of cur-
rent resources allows the organization to map out how
its staffing can evolve over time, as well as determine if
gaps exist. The next step is to develop an action plan by
identifying strategies to close the gaps, such as recruit-
ing and training new talent, developing talent internally,
restructuring, adopting technological enhancements,
subcontracting, or any combination of these. Savvy or-
ganizations then look to strategically implement their
workforce action plan—and proactively monitor, evalu-
ate, and revise the plan as it is being executed.
For example, if your organization plans to open three
new branches in the next five years, you would need
three branch managers, a certain number of pharma-
cists, technicians, nurses, and so on. Given the cost of
hiring—and the chance that a new hire may not stick—
it’s far more efficient to fill needs from within the orga-
nization whenever possible. Armed with a quality work-
force plan, it’s possible to identify team members with
the potential to fill future roles and successfully align
workforce requirements directly to plans.
Today’s clinical pharmacist, for example, could take
on more managerial responsibilities, develop as a lead-
er, and step into a branch manager role in a few years. It
might also be worth looking at your team’s skill sets and
interests in a new way. Obviously, a customer service
specialist isn’t going to assume the role of pharmacist,
but maybe that person is sufficiently detail-oriented and
understands enough about insurance coverage and bill-
ing to move into reimbursement. In this case, an honest
assessment of personal interests, goals, and career di-
rection is in order.
Tools such as succession planning, mentoring, training
and education, and coaching can all be used to “build”
current talent to meet future needs. While it’s true that
fostering professional development is an investment
that can “walk away” if the employee leaves, most orga-
nizations find it worthwhile in terms of enhancing work-
er skills and engagement—and, highly engaged employ-
ees are much more likely to be retained.
According to Gallup, employees are more engaged
when they feel like they have the opportunity to learn
and grow, are encouraged to develop their careers, and
are cared about as people.4
With only 29% the U.S. work-
force “actively engaged” in their jobs, why not encour-
age that passion and commitment in your current team
Exhibit 1
Workforce Planning Model
Source: U.S. Office of Personnel Management
Step 1:
Set Strategic
Direction
Step 2:
Analyze
Workforce,
Identify Skill
Gaps, and Conduct
Workforce
Analysis
Step 3:
Develop
Action
Plan
Step 4:
Implement
Action Plan
Step 5:
Monitor,
Evaluate,
and Revise

4. JANUARY/FEBRUARY2015
39
www.nhia.org/CE_Infusion
Continuing Education
members when possible?5
The devastating alternative
could be disengaged team members who feel unrecog-
nized or “passed over” for new opportunities—exactly
the type of employees who are more likely to leave, re-
sulting in higher turnover rates (and associated costs).
Building talent to cover positions before an acute
need arises is especially critical at this point in the home
and specialty infusion industry’s life cycle. Three de-
cades in, the maverick pharmacists, nurses, and entre-
preneurs who gave rise to this field are beginning to
leave the workforce. In a niche industry, that type of
turnover can create a brain drain. This creates a work-
force environment where succession planning is a major
challenge—and also a competitive advantage for those
organizations that successfully tackle it.
This potential for industry brain drain is coming at a
bad time given the context of national trends. As we
emerge from the economic stagnation of the recession
and the employment outlook brightens, more Americans
are looking for—and finding—work. According to Price-
waterhouseCoopers (PwC), voluntary separation rates
are increasing, and are especially pronounced among
critical populations, such as high performers (the top 20%
of an organization’s performance management system)
and high potentials (those identified as having leadership
potential and in line to move into senior roles).6
In an analysis of data reported by more than 300 or-
ganizations, turnover for both groups increased substan-
tially in 2012. The high-performer employee separation
rate rose nearly 14%—almost three times higher than the
5% increase in overall voluntary turnover.6
The same anal-
ysis showed a similar pattern for high-potential employ-
ees, with voluntary separation increasing nearly 17% from
2011 to 2012. With more job movement, these individuals
become even more valuable, and organizations will have
to proactively compete to attract, engage and retain this
key talent. Because replacements typically require high-
er pay, organizations should unquestionably consider
increasing efforts to engage and retain their employees,
thereby curtailing costs associated with turnover.
External Hiring
Sometimes the needs outlined in the workforce plan
cannot be met internally. Then it is time for an organi-
zation to acquire or “buy” new talent to augment its hu-
man capital. This looks different for every organization
based upon a variety of factors, including: location(s),
required skill sets, strategic goals, and more. With nearly
one in four employees leaving—voluntarily or involun-
tarily—within the first year of tenure, it’s important for
an organization to effectively recruit, onboard, and re-
tain new hires.6

5. JANUARY/FEBRUARY2015
40
www.nhia.org/CE_Infusion
Continuing Education
The first step is to know and communicate the job re-
quirements for each position. This can be especially chal-
lenging for rapidly evolving organizations whose needs
can morph quickly. Hiring quality may suffer, which can
increase turnover. According to PwC, an employee’s
leaving within the first year typically signifies poor fit.6
If the turnover cycle picks up, the growing pressure to
hire quickly can result in more poor hires, which feeds
this negative cycle. An influx of new hires puts pressure
on assimilation and learning, creating a greater need for
extended onboarding programs.6
It’s also important for an organization to accurately as-
sess candidates to ensure that their skills and personality
are a good fit with both the position and with the organi-
zational culture. Typical steps in the process include phone
and face-to-face interviews along with checking referenc-
es. Some organizations use skill assessments, background
and drug screening, and personality screening. These are
all very useful tools in helping identify the ideal candidate.
Assessing a candidate occurs on both a personal and
a professional level. Obviously, the easier, and more ob-
jective, of the two is to evaluate professional credentials,
which can be accomplished by reviewing education, work
history, licensing/certifications, or even job shadowing.
Evaluating personality is more subjective, and also
subject to privacy regulations. Home infusion is a very
outward-facing industry, where interactions with pa-
tients and referral sources can make or break a provid-
er’s reputation. In addition, many provider companies
are heavily involved in the community. New hires must
not only be a fit for the company but also the surround-
ing community—including patients, families, and other
health care entities. What makes this so tough is that
when interviewing for a job, everyone tries to put his or
her best foot forward. The person you meet in an inter-
view with terrific energy and that “it” factor may not be
the same person three months into the job.
One way to prevent this mistake is to build a profile of
the ideal candidate. Begin by looking at current employ-
ees and organizational leadership. What traits or charac-
teristics do they possess that are desirable in future em-
ployees? What do the top nurses, liaisons, and patient
advocates have in common? With a sketch in mind, tai-
lor interview questions to extract the information that
will help determine if a candidate fits the given profile.
A time-tested way to do this is by asking questions that
force the candidate to relay meaningful examples from
their personal and professional experience.
Another useful tool is a personality assessment instru-
ment. There are several proprietary screening systems
available that measure personality traits as a predictor
of job performance. While these tests will offer an ac-
curate profile of the person taking the assessment, they
must be applied correctly in order to reach the desired
results. For example, companies that arrange for their
employees—regardless of work history or production
level—to take one of these types of assessments are
likely to discover that many of the higher performers
share several key traits. Then, after strategically hiring
for those traits, such companies are likely to attain a

6. JANUARY/FEBRUARY2015
42
www.nhia.org/CE_Infusion
Continuing Education
higher retention rate, improved outcomes from new
hires, and, as a result, an enhanced company culture.
Every organization has an interview process, but they all
approach that process differently—from the number and
types of questions to the number and backgrounds of the
people in the room. How you progress through the steps
is a reflection of your organizational culture. Common
mistakes include drawing out the process too long and/or
not clearly communicating the process to candidates.
Ideally, the interview process should take two weeks,
certainly no more than three. Resist the temptation to
wait in hopes of attracting a superstar. Time and time
again, organizations often find their best candidates
within a week of opening a search. It is critical to have a
clearly defined process and share that process with the
candidates so they know what to expect.
Attracting Talent
When considering an open position, always be aware
of the talent in the field. The ultimate example of this is
the National Football League (NFL), where teams invest
upwards of $2-3 million each year on their scouting de-
partments. NFL scouts spend hundreds of hours watch-
ing video, conducting private workouts, and reviewing
Scouting Combine results, which evaluate a player’s
physical abilities and mechanics.
Clearly, home and specialty infusion businesses don’t
have such resources to put toward tracking talent. How-
ever, members of your team interact with others in the
field all the time. Is there a way you can harness this
wisdom and experience to identify talent for future re-
cruitment? Think about which colleagues consistently
show that they are mission driven. Who shares knowl-
edge and expertise? Who has proven to be a leader or
“doer” as part of committee or task group?
There are two types of candidates: active and passive.
While active candidates are pursuing new job opportuni-
ties, passive candidates are typically content in their cur-
rent position, but might consider an opportunity if it ap-
peals to them. These passive candidates are thought to
be more desirable because they have solid performance
histories and are in “good standing” in their current
roles. Reaching and appealing to passive candidates,
however, requires more work and creativity.
The talent an organization attracts is a direct reflec-
tion of how it is perceived within the industry and the
community it serves. Perception is reality, especially
in a tight-knit field like home and specialty infusion. A
provider’s identity is one of the most important things a
candidate will take into consideration before making his
or her decision. Where is the organization headed? Does
it promote a team environment—one where employees
can work collaboratively and their ideas will be heard? Is
there open communication between departments and
employees? Does leadership support the team and give
it the tools necessary to succeed?
It’s important to remember that the candidates you
want for your company are also being sought by your
competition. Offering a competitive compensation pack-
age is one of the most important factors in successfully
bringing desirable talent onboard. Successful organiza-
tions regularly evaluate their compensation packages to
see how they compare to others in the industry. They
think creatively about compensation as a way of en-
gaging employees and fostering performance (more on
compensation later).
Onboarding is a key precursor of both performance
and engagement. Successful programs can effectively
spur productivity and retention, while poorly conceived
or executed programs can fail to assimilate a new hire,
deflate morale, and increase voluntary departures—af-
ter all that new hire was recently in the job market and
can easily resume the search.
Successful organizations typically run longer pro-
grams with more frequent assessments along the way.
Despite this, PwC’s data shows that 40% of organizations
have onboarding programs that last one week or less
(see Exhibit 2).6
PwC notes that high-performing organi-
zations extend onboarding throughout the first year of
tenure through mentor assignments, networking oppor-
tunities, recognition programs, formal goal setting and
career development, and training courses.6
Of course, length of training time isn’t everything.
The quality of the experience is also a key to rapid and
Exhibit 2
Onboarding Program Length
Source: PwC Saratoga’s 2013/2014 U.S. Capital Effective-
ness Report
How long is your formal onboarding program?
0
20%
40%
60%
80%
100%
3-12 months 15.4%
1-3 months 25.3%
1 month 9.9%
1 week 25.3%
1 day or less 24.2%

7. JANUARY/FEBRUARY2015
43
www.nhia.org/CE_Infusion
Continuing Education
successful assimilation. For this reason, successful or-
ganizations routinely check in with new hires to assess
how they are feeling and if they have any questions or
are struggling in any way. Measuring and enhancing the
new-hire experience can help mitigate turnover by im-
proving employee assimilation within the first months
of tenure, accelerate the time to full productivity, and
set the stage for high employee engagement.6
Assess-
ments are typically performed at one-month following
the start date and six months later, after the employee
has settled into his or her new role.
Strong Foundation for Teams
Attracting and retaining talent involves many of the
same principles regardless of whether the organization
is “building” or “buying.” A strong foundation of orga-
nizational fairness and trust is greatly desired within the
typical workforce, backed closely by other factors, such
as compensation, strategic direction, and opportunity.
Overall, an organization can boost its talent pool by in-
creasing its overall value proposition, which in turn, in-
creases engagement and boosts productivity.
When a candidate is asked why he or she might con-
sider a new job, the answer is often fairly universal. Sur-
prisingly, it doesn’t revolve around money. People want
to know that they are progressing in their career. For
some that means advancement into a leadership role;
others are looking to be challenged. The next most pop-
ular reasons for considering a new job are because the
employee doesn’t feel valued or respected by his or her
current employer. Make sure to ask your current em-
ployees and prospective candidates what they hope to
accomplish in their careers and discuss candidly whether
or not you’ll be able to offer that to them.
It is not always the primary driver, but compensation
is a strong factor in employment decisions. After years
of flat salaries, recent competition in the job market
has sparked a new need for attractive compensation
packages. Unfortunately, the steady rise in health care
costs—as much as 7% per employee in 2012—has caused
many U.S. employers to reduce their investments in
non-health care benefits.6
Though it may keep costs in
check, a shrinking compensation package can erode the
employee value proposition, which can increase the like-
lihood of employees seeking other opportunities. From
the internal “build” perspective, it’s more effective to
make the necessary investments to engage and retain
employees than incur the costs associated with turn-
over, hiring, and onboarding. From the external “buy”
perspective, competitive compensation packages in-
crease the organization’s chances of attracting and re-
taining quality new talent.

8. JANUARY/FEBRUARY2015
44
www.nhia.org/CE_Infusion
Continuing Education
It’s important to note that compensation is much
more than just salary and benefits. Opportunities for
professional development, flexible scheduling, perfor-
mance-based incentives, profit sharing, and more all
combine to create a package that can make employees
feel recognized and appreciated.
Employee engagement is a critical ingredient in the
overall value proposition. High engagement can have
numerous positive business results, including improve-
ments to retention, innovation, customer service and
loyalty, revenue, profits, and safety.4
PwC’s analysis
shows that most organizations embrace the idea of em-
ployee engagement, with 86% measuring it in some way.
However, remarkably few organizations take action as a
result of their engagement surveys.6
More than half the organizations surveyed (59%) don’t
require managers to develop a plan for employee en-
gagement (see Exhibit 3).6
Because of its many benefits,
and because measuring employee engagement creates
an expectation that feedback will be acted upon, PwC
recommends that organizations hold managers ac-
countable for developing an enterprise plan to preserve
strengths and improve priority areas, communicate up-
dates, and conduct follow-up surveys to measure im-
provements.
Whether you “build” or “buy,” investing in your em-
ployees is always a wise choice. At the end of the day,
a uniquely qualified talent pool is the way forward in
achieving business goals, advancing company creativity
and innovation, and strategically executing the organi-
zational mission. Success requires many resources, but is
impossible without human capital!
References
1. Brannick J. Decreasing the staggering costs of turn-
over in your organization. 2000.
2. Branham L. Keeping the people who keep you in busi-
ness: 24 ways to hang on to your most valuable talent.
2000. American Management Association.
3. U.S. Office of Personnel Management. Workforce
Planning Model. Available at: http://www.opm.gov/
policy-data-oversight/human-capital-management/
reference-materials/strategic-alignment/workforce-
planning.pdf (accessed 12/31/2014).
4. Wagner R and Harter J. 12: The Elements of Great
Managing. 2006. Gallup Press, New York, NY.
5. Krueger J and Killham E. Who’s Driving Innovation at
Your Company. Gallup Management Journal. 14 Sep-
tember 2006. Available at http://gmj.gallup.com/
content/24472/whos‐driving‐innovation‐yourcom-
pany.aspx#1 (accessed 12/31/2014).
6. PwC. State of the Workforce: Results from PwC
Saratoga’s 2013/2014 US Human Capital Effectiveness
Report. 2013. Available at http://www.pwc.com/
en_US/us/hr-management/publications/assets/
pwc-saratoga-human-capital-effectiveness-report.
pdf (accessed 12/31/2014).
Exhibit 3
Measuring Employee Engagement
Source: PwC Saratoga’s 2013/2014 U.S. Capital Effectiveness Report
Does your organization
measure employee engagement?
Are directors/managers required to
develop an action plan for engagement
of employees who report to them?
NO
14.0%
NO
40.2%
YES
86.0%
YES
59.8%