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Dear IHI: How Do I Hire Improvement-Minded Staff?

By Audrey Lampert | Thursday, June 23, 2016

Dear-IHI-value-of-failed-pdsa-health-care-improvement

DEAR IHI — 

I’m a new manager in an integrated health system, a big believer in continuous improvement, and I’m about to hire a new staff member. I know that teamwork is essential to learning from mistakes and constantly seeing and solving problems. How do you hire people who are committed to improvement and being part of a learning team? – HIRING MANAGER

Dear Hiring Manager —

I’ve been working in HR for years, and I’ve found that every candidate and organization is different.

One organization I worked with strongly believed it was critical for every member of the executive team to be humble. To test this, they developed a “dishwasher test.” 

Here’s how it worked: At some point during the interview, someone from HR would offer each candidate a tour of the office. Along the tour, the HR person would stop and start emptying the dishwasher without pausing the conversation. If the candidate helped, offered to help, or at least looked unsure about what to do, they passed the test. If, on the other hand, the candidate kept talking without a remote possibility that they might consider emptying the dishwasher, he or she wasn't invited back.

At IHI, we focus on improvement. When reviewing resumes, we look for candidates who have shown growth and progress throughout their academic and professional experiences. The interview gives us a chance to dig in further with two key questions about improvement, which we actually send to candidates ahead of time. We’ve found that this helps to alleviate some of the anxiety around interviewing, and creates more meaningful conversations during our brief time together.

  • “We are an improvement organization, and we really believe in improvement. What’s one thing you are working to improve about yourself?” This first question is direct on purpose. We listen as candidates share their personal journeys and try to determine if they’re excited and passionate about self-improvement.
  • Please tell us about the project or piece of work you're most proud of.” This question leads us into a second conversation that’s more subtle. After listening to a candidate talk about a project that they care deeply about, we then ask them what they would have done differently. Candidates who are improvers at their core have already thought this through, and it shows in their responses — they were likely making note of how the project might have been better while it was happening. Candidates who get excited talking about their learning and future possibilities are natural improvers.

Of course, depending on the position you’re hiring for, you may be tempted to ask much more specific and advanced questions about quality improvement methods. Personally, I would be careful not to get lost in the jargon. A lot of health care professionals these days know that improvement skills are something that employers are looking for. I’ve found that it’s often more effective to cut through the jargon and buzzwords to see if the candidate is passionate about the two jobs that are essential to working in an improvement organization: doing their daily work, and improving it.

Last, hiring is a team activity, too! At IHI, we make sure that diverse hiring teams participate in the interview process. Like anything else, different perspectives can be incredibly valuable when making such nuanced judgment calls as hiring a new team member. It also helps the team feel that their input matters, and helps the new staff member integrate more quickly when they come on board.

Good luck,

Audrey Lampert, IHI Human Resources

Editor's Note: "Dear IHI" is an advice column in which IHI experts answer questions from health care change agents in the field. Leave your advice in the comments. Have a question for "Dear IHI"? Send it to info@ihi.org or on Twitter using the hashtag #DearIHI and @TheIHI.

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