Reduce involuntary terminations by focusing on behavioral competencies

Give hiring managers the tools to identify candidates who fit the culture



This regional community hospital system is representative of the challenges facing most smaller health systems. It is moving to a high performance, integrated system, from two very different hospitals – all under relatively new leadership. The system is reinventing itself to meet the needs of its community. They want to attract and retain people who are adaptable and suited to this culture.

An in-depth cultural assessment by the Talogy team revealed that employees were struggling with new high-performance expectations, including adapting to a lean process program. The organization reached the conclusion that some employees aren’t suited to a high performance culture. Analysis also revealed that many nurses, rather than taking a “patient-centric” approach to their work, were more “nursing-centric” – i.e., their day and approach were built around what they believed were their specific nursing duties – not the patients’ needs.

Senior leadership realized their process improvements and patient-satisfaction programs would be futile if they didn’t take a more deliberate approach to who they hire. They also realized that managers were not ideally suited to make selection decisions, as evidenced by exceptionally high early “for cause” termination rates. It was not uncommon for a hiring manager to choose, for instance, a patient care technician or nursing assistant based on the resume and interview, only to find out soon after starting that the employee had serious behavioral and performance issues or simply didn’t fit the new culture.



Leadership tasked Human Resources with finding an approach that would identify people better suited to the culture they envisioned, and in the short term, reduce the early “for-cause” terminations. The Talogy Healthcare Consulting team built a comprehensive selection system by defining key behavioral competencies, implementing Interviewing Solutions (formerly known as Select Interviewing®) and pre-employment behavioral screening integrated with the applicant tracking system.

What does a comprehensive selection system: look like?

  • Define the important and predictive behavioral competencies you need to target (i.e., dependability, attention to detail, collaboration, adaptability, patient focus)
  • Build these competencies into the selection system, including:
    • The application process
    • The resume review process
    • Talogy’s healthcare solutions – custom designed job family level interview guides and hiring-manager training
    • Talogy’s pre-employment behavioral assessments


The same behavioral competencies were then built into the performance management system so that staff are evaluated on the same behavioral skills that are the focus on the selection process.


involuntary terminations 90 days graph
There was over an 80% reduction in early (90 day) involuntary terminations.
involuntary terminations first year graph
And a similar reduction when looking at terminations after a full year.



You can’t build a new culture with the wrong people. This system was struggling to build the right team for a high-performance culture, but as many as 15% of new hires were quickly revealed as not having what it takes. This means that human resources’ time and energy were constantly finding candidates to fill the same positions. The new selection system and tools gives hiring managers the tools to do a better job identifying candidates who are suited to the new culture. With the right people on board, the system can now focus on making the other important changes that drive a high performance culture.