HIRERIGHT HOLDINGS CORPORATION In our last blog on healthcare perspectives on drug screening, we explored unique hiring challenges in the industry, post-pandemic. Healthcare organizations have faced exceptional, and sometimes devastating, staff shortages over the last few years. Nearly one in five healthcare employees quit during the pandemic, and close to 12% were laid off. Added to this, burnout is huge in the healthcare industry. This all leads to an unsurprising outcome: a workforce that is rapidly growing smaller, and a desperate need to fill these positions.
We know that the background screening and drug tests needed in this industry can take time. Employers are looking for ways to hire faster, and some may be considering removing drug testing from employment pre-screening. However, we see that this offers its own set of challenges, as the healthcare workforce is also an at-risk employee type for illicit drug use and addiction due to a variety of factors unique to the industry, as discussed in a prior HireRight blog (hyperlink to previous blog). Rather than remove vital drug screening services, we recommend seeking other alternatives to get candidates onboarded faster while still taking meaningful steps to protect your workforce and patients.
In this blog, we will explore some of the challenges that healthcare employers face when building a workforce, as well as ways to overcome those challenges and get candidates in the door faster.
What do healthcare organizations generally screen for?Pre-employment Drug and Health screening requirements in the healthcare industry are some of the most intense for employers, usually including occupational health screenings, vaccination history, and drug testing. These requirements take time to complete and can make the hiring process feel cumbersome. Here is what most healthcare employers typically screen for in the U.S.:
TB Screening and Testing
Baseline TB Risk Assessment
TB Symptom Evaluations
TB Testing - Blood or skin test
Chest X-ray
Vaccinations and Immunity Verification
Collect Health/Vaccination History
Titer
Vaccinate
Capture Declination
COVID, Hep A, B, Influenza, MMR, TDAP, Varicella
OSHA Respiratory Questionnaire
Drug Testing - Pre-employment, ongoing drug screening and monitoring
Employers in the healthcare industry face several challenges to screening candidates. They need to manage a candidate's health history, various forms of documentation, scheduling testing, and receiving results from multiple sources. Here are some of the challenges:
Multiple systems often used to manage different services
Candidate experience and variable response time
Scheduling issues
Product consistency
Multiple clinic visits
High fees
Extended Result TAT (turnaround times)
Continuous oversight and management
Improving the turnaround times for these drug and health screening services can help employers continue to hire their staff quickly, while maintaining safety sensitive screening services like drug testing.
HireRight recently held an online event with experts in the healthcare space to talk about methods to reduce their turnaround times. Here are three steps that employers can take, as shared in the webinar, to speed up turnaround times:
1. Capture documentation and intent as part of the candidate experience- Much of the screening documentation, such as vaccination history, medical history, TB and OSHA assessments, questionnaires and declinations, can be captured as a part of the upfront screening process. Additionally, if you have the right tools in place, the process can move along quickly.
What you need:
Electronic and dynamic questionnaires that allow for uploading of records and bypassing questions when they don't apply
Simplified management of documentation and records so you can access when you need it
Quick processing and immediate access to answers and documentation
2. Automatically Trigger Scheduling of Services - Some services may or may not be needed, based on the information that you have captured from the information provided by the candidate. For example, Tilters, TB tests, or vaccinations may or may not be needed based on their health history. Chest X Rays will only be needed based on a positive TB test. Having a system set up that automatically triggers these additional services can minimize back-and-forth with a candidate to find out what is needed.
What you need:
A system to auto-trigger notification to candidate on next steps
Simplified candidate experience - one site visit for all services needed
Status updates on process - when candidate visits the site, testing is complete, results are ready
3. Develop a fast and streamlined process for blood testing- Titers TB Blood Tests and TB Skin Tests are a part of the process that often takes the most time and can incur high costs. Streamlining the process with a network of providers can help you get your candidates tested quicker, and often at a lower cost than using multiple service providers.
What You Need:
A Licensed Provider Network for all 50 states+ that provide rapid testing and results
A wide network of laboratory-owned patient service centers and other clinic networks throughout the U.S. These labs are a lower cost solution that offer opportunities to schedule blood tests vs TB Skin tests
Less clinic visits for the candidate
Faster turnaround times
Lower cost to the employer
The ability to instantly create requisitions for bloodwork that includes physician provider and laboratory integrated in the results
Instant reporting of results from lab when complete
Healthcare drug testing has traditionally required all specimens be sent to an accredited laboratory for testing. The collection and ensuing transportation to the laboratory can be fraught with delays. However, there are ways to address this issue.
1. Urine Point of Collection Testing (POCT) - There are urine test kits available that can reliably test specimens within minutes for potential evidence of drugs. These initial tests using immunoassay technology are fundamentally the same as the initial tests run by the accredited laboratories. Any initial positive (non-negative) test needs to be sealed and sent to an accredited laboratory for confirmation testing since the POCT result is not actionable unless it is negative (meaning no drugs detected). This process can be done as a service offering at some clinics, and if you are willing to collect urine specimens yourself, can easily be done at your company location.
What You Need:
Determine if available urine POCT's meet your panel requirements
Decide if you are willing to conduct the collection and initial testing yourself
Reading these POCT is generally the same as reading a COVID test
If you rather have this process completed at a clinic, contact your drug screening provider to see what clinics within their network provide this service
2. Oral Fluid POCT - Healthcare has not embraced oral fluid testing like other industries. One chief reason for this is that oral fluid tests traditionally have had a very small panel compared to urine tests; however, in recent years this issue has been addressed. Now there are oral fluid POCT that test for benzodiazepines, barbiturates, hydrocodone, oxycodone, and methadone beyond the illicit substances in standard drug test (THC, cocaine, amphetamines, opiates to include heroin, and PCP). Further, unlike urine, the collection process is easy and does not have the nuanced challenges of urine collection. Another value proposition for oral fluid POCT is that there are suppliers of these devices that leverage cellphone application readers to take the reading of the POCT out of the hands of the person collecting, and just like urine POCT, all non-negative results need to be sent to an accredited laboratory for confirmation testing. One other draw back of oral fluid POCT that differentiates it from lab based oral fluid is that the detection of THC is massively diminished. This is due to the immunoassay test cutoff level for THC in oral fluid POCT being much higher than what the labs can support; therefore, the window of detection in oral fluid POCT is only a few hours;. Even though there is a challenge with the THC test, the testing for all other analytes is the same between the lab and oral fluid POCT device.
What You Need:
As mentioned above, determine if available oral fluid POCT's meet your panel requirements
Work with your drug testing provider to see what devices they have available since the collection, device reading, and what is required for confirmation testing depends on the devices they offer
In healthcare screening, the volume of assessments, testing, and waiting on results can cost an employer time, money, and possibly a future candidate. Although it may be tempting, eliminating vital services like drug screening may not align with the risk management strategies healthcare organizations typically adhere to. Fortunately, there are ways to improve screening turnaround times while maintaining risk mitigation measures in place. Employers can have solutions put into place that capture important documentation as a part of the candidate experience, have a system of triggers set up to automatically order services, and integrate blood testing services.
Working with a professional screening provider can help you solve these challenges with built-in solutions such as medical questionnaires, provider network capabilities, and automatic scheduling. Learn more about HireRight's Healthcare Solutions.
Release Date: January18, 2023
Ms. Lundregan joined the HireRight team in March 2012. She supports HireRight's healthcare clients, providing compliance insight on screening requirements, products, and service, as well as reviews screening programs and offers peer practice benchmarking. She brings with her more than 15 years of experience in assisting healthcare organizations in implementing compliance programs, drafting, and delivering training programs, and supporting compliance initiatives and sanctions screening tools in the healthcare private sector. In addition, Ms. Lundregan was the program manager on government sector projects related to Program Integrity, working with the Centers on Medicare and Medicaid Services (CMS) and other companies to audit and monitor fraud and abuse programs. She brings an understanding of compliance and the regulatory environment in healthcare. Ms. Lundregan holds a B.A. from the University of San Diego and a M.A. from American University in Washington, DC.
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HireRight Holdings Corporation published this content on 18 January 2023 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 18 January 2023 18:49:04 UTC.
