HTM leaders share how they’re helping to find the next generation of talent
By C.A. Wolski
With 10,000 baby boomers reaching retirement age every day, according to AARP statistics, and an increasing demographic shift from mechanical and hands-on professions, many healthcare organizations are finding it increasingly difficult to fill the ranks of its clinical engineering departments.
However, that doesn’t mean that there isn’t a solution to this potentially thorny problem. In fact, many organizations are facing the problem head-on, and are using a variety of strategies to replace its retiring or revolving workforce. These techniques include internships, creating a rewarding environment, and grooming successors by cultivating a culture of excellence.
Finding the Next leaders of HTM
To help fill vacancies created by retirements and new positions, the Veterans Health Administration (VHA) relaunched its Technical Career Field (TCF) program in 2003. The program, which seeks to train those with the VHA’s “biomedical engineer” and “biomedical technician” job titles, has served a unique purpose, according to Michelle Baquie, national TCF program manager for biomedical engineers and technicians.
Since the biomedical engineers trained in the program are largely new grads and the biomedical technicians represent a variety of backgrounds—some boast college and advanced degrees; others offer military training certificates—the TCF program covers the bases, maintains Baquie. An alumna of the program herself, Baquie says two key things the TCF does right is emphasize HTM program management and translate the technical needs of the medical staff into practical solutions.
No matter the track, however, the TCF isn’t a typical internship. Instead, Baquie explains that those who go through the two-year program receive a full salary plus benefits, including healthcare and credit toward retirement pensions, with the assumption that those who graduate will stay on with the VHA for part or all of their career. In addition, the interns receive a yearly stipend of $10,000 to attend conferences, such as AAMI Exchange, or pursue training outside of their program.
But the monetary benefits, albeit impressive, aren’t what makes the VHA’s program so noteworthy, argues Baquie. It’s the approach. “The majority of training comes from preceptors,” she says, with the one-on-one mentoring continuing through the duration of the two-year program.
Although the TCF program has been largely successful—retention hovers around 85%—some challenges remain, Baquie acknowledges. For starters, while the biomedical engineering applications routinely result in an embarrassment of riches with up to 400 applicants for the 15 slots, that’s not the case with the 15 general biomed positions, says Baquie. “Our turnover has been mainly with the technicians,” she says. “The challenge is that they don’t really understand what they’ve gotten themselves into and that it is an entry-level position.”
To remedy this, the VHA uses an ambassador program, where VHA biomedical staff go into local high schools and colleges to provide a glimpse into the world of HTM, including what a normal day looks like, the general career path, and opportunities for growth. She says that there are also partnerships with universities and opportunities to leverage relationships with local associations to find potential TCF candidates.
So just who is the ideal program candidate? Baquie explains that the right candidate has a combination of technical know-how and a customer service orientation. On occasion, an intern may be very technically oriented, but not as strong on the customer service side, or vice versa, which often means that they will leave the program early.
Another program challenge is generational. “Research shows that millennials don’t stay in jobs as long,” Baquie says. “We have to figure out what people love to do and find ways to incorporate that with the other routine tasks.”
As a sign of the TCF program effectiveness, Baquie says that alumni are regularly poached from the VHA to go work for other organizations. Even so, she considers it a win. “I don’t mind sharing them with other organizations,” Baquie says. “The staff are going to learn new skills and will hopefully come back to us stronger.”
During the three years that Ilir Kullolli has been the director of clinical technology and biomedical engineering at Stanford Children’s Health in California’s Silicon Valley, he has emphasized creating redundancy to address staffing challenges. “We have always been adamant about having redundancy in every position,” he says. “This is not only to provide succession, but also needed for day-to-day operations. From the day I joined my organization, having that redundancy in place became a priority.”
So far, Kullolli has only had two team members retire, with minimal impact on the department. “These two retirements didn’t affect the organization much because we performed a slow transition of the retirees’ duties over to current staff,” he notes. “Then we hired younger staff to fill in the openings and [simply] provided them with additional training—on-site and OEM training.”
While this emphasis on redundancy has helped lessen the impact of retirements and other staff changes, Kullolli says that he still faces two challenges in finding his next generation of talent.
Firstly, in large part, the training younger biomeds are receiving hasn’t changed much in the past 20 to 30 years. “Their training is not reflecting what the world of clinical engineering has become in the last decade,” says Kullolli. Still, younger HTM professionals often come equipped with specialized skills, he acquiesces. “In general, the new biomeds are a lot quicker with computers and phones,” Kullolli says. “They want to have everything handy, and don’t really like to go back and use a computer if they can use a phone for everything. However, when it comes to equipment safety and taking their jobs seriously, they are just as serious as the older biomeds.”
The other challenge is a specifically central California-related issue: the high cost of living. “Our organization is in the middle of Silicon Valley and finding and retaining staff is always a challenge,” he says. “Most of us cannot afford to live where we work, so it is hard to keep staff around when they have to deal with hours of commuting.”
Even in the face of these two concerns, Kullolli has largely retained the staff he began with three years ago. He credits this to the work culture he’s developed. “We have made the workplace enjoyable for them, have ensured that they continue to get relevant training, and have kept them engaged in their jobs and with each other,” he says.
The HTM professionals he has hired have primarily been the result of referrals, including new employees bringing their friends to the organization. Kullolli also has his staff regularly attend local clinical engineering society events to network and find potential candidates. When asked about what has been the most surprising aspect of his focus on redundancy and retention, his answer reflects what he has tried to instill in the organization. “Not really a surprise, but just the fact that I couldn’t just pick one or two people as successors—so many of them fit the criteria!” he says.
Passing the Baton
When Mark Heston was being interviewed to be director of clinical engineering at Children’s Hospital of Colorado in Denver, he made a surprising admission to the search committee: he planned on retiring in seven years. But then, he made them an offer: “If you want someone to help you transition to the next director, I’m the guy,” he says, recalling the interview. “I think—I know—they liked that candor.”
That was six months ago. As a result, Heston was hired to find his own successor, which he hopes will be one of the 80 biomeds currently working at Children’s Hospital of Colorado. To that end, he’s already, by his own admission, doing “a ton of delegating,” and empowering his fellow HTM professionals to make mistakes and learn from them. “I’m looking for who’s taking initiative, and then who comes in and says, ‘I screwed up,’ which is a sign of a good leader,” Heston explains.
As part of that, he’s looking for resilience; he says that he wants to see how that individual bounces back from that mistake and takes the lead on the next idea he or she comes up with. While it’s no secret that Heston is looking for his own successor, he expects it’ll be several years before he has identified the right candidate. But the succession goal is broader and more far-reaching than just finding the next director.
“The goal is to elevate everybody,” Heston says. “I’ll be spreading the wealth of knowledge as much as possible. I’m setting everybody up for success and growth.” As a result, Heston has been transferring his knowledge through a series of “office-hour” type meetings in one of the hospital’s conference rooms every other week, when department members can come in and ask any question they want.
Heston is also keeping department members in-the-know about his job tasks. For example, because his successor will need to understand the financial aspects of the job, he has a team member accompany him to meetings with the finance team. And that goes for every other type of meeting he has—other than anything of a sensitive nature, such as personnel matters—a member of the clinical engineering department is always shadowing him. During his short tenure, Heston has already witnessed the effect this approach has had on the clinical engineering team. “What I’ve noticed is that being open and transparent has resulted in more engagement by the biomeds,” he says.
On the flip side, Heston says that he is fully aware that the knowledge of his search for a successor could develop into a cutthroat environment. He has zero tolerance for this behavior, however: “No backstabbing or diabolical behavior allowed—period.” Heston adds that the “one-for-all, all-for-one” philosophy has significant benefits. “If one succeeds, we all succeed—and we celebrate that,” he says.
Heston’s next stop on the road to naming a successor is designating specific HTM “champions” (e.g., work order, shop safety) as a way to cultivate leadership qualities among the clinical engineering team. And while his succession plan is energizing and engaging his team, the final sign of success is still years away. “The reward will come when I walk out the door,” Heston says.
The Sky’s the Limit
As Baquie, Kullolli, and Heston’s examples show, there is no single answer for beating the succession challenge except creativity. Approaching the problem as one that can be solved will likely unlock a range of options that fit your organization’s specific needs and circumstances, they say.
Proactivity is also key, the experts consulted here agree. The VHA, Stanford Children’s Health, and the Children’s Hospital of Colorado programs are arguably staying ahead of the problem of retirements and millennial job-hopping, and that’s giving them the room to try out-of-the-box solutions and make adjustments as necessary—instead of passively waiting for biomedical staffing to hit a crisis phase.
The bottom line, according to Kullolli? No matter what form your succession plan takes, remember the most important element in the equation: the biomed. “I would advise leadership to not only think about the succession plan, but to look at the big picture and put themselves in their employees’ shoes,” he says.
Good leaders should seek to cultivate talent among their employees—rather than simply looking to fill a role. After all, Kullolli says, “If you are only thinking about a succession plan, you end up limiting what an employee can achieve by defining a ceiling for them.” Instead, leaders should strive to help employees become “the best they can be—and whether they stay with the organization or not should become secondary.” By following this approach, Kullolli says, you can help good employees stay engaged—“and, hopefully, convince them to stay with the organization.”
C.A. Wolski is a contributing writer for 24×7 Magazine. Questions and comments can be directed to chief editor Keri Forsythe-Stephens at firstname.lastname@example.org.
Very forward thinking processes for finding succession. This would be fine if you have the allow ability to pre-hire before you have a deficiency occur. What it doesn’t really address is the rest of the Biomed organizations and departments that will be in need of replacements and no clear path to find them. Combine that with the declining numbers of schools, it is going to be difficult at best to keep our heads up above water and maintain an expectable number of tech’s. Recruitment prior to high school graduation has to be occurring across the country.
Sad to say but the person’s who would participated in this article have only one goal and that is to promote their career and vision of what they think Biomedical engineering should look like. Technicians are valuable but when you decide they can only be a person who can hold a screw driver and can’t access a PC and troubleshoot a network problem without an engineers help is completely false and a shame. Mr Kulloll’s approach is to hire younger workers and everything will be just fine, but tell me how would you feel if you saw a manager or director just look at you like your totally replaceable and can be found off the street in a week? This is why technicians are leaving the field because upper leadership takes mobility from the technicians and gives it over to engineers. Engineers have a place in biomedical engineering but everyone can’t be one and before you know it the scales have tipped to far (Top heavy engineers) and not enough skill techs you can count on.