High Volume Recruitment of Direct Hire Staff – FocusOne Case Study

FocusOne Solutions was engaged to assist a large, Level 1 trauma center located in North Dakota with a sizeable, multi-phase hiring effort.

Our partnership began in 2016, one year prior to the opening of the state’s newest and largest hospital, a $500 million, 12-floor, 284-bed facility.

The facility faced significant challenges impacting its ability to right fit staffing levels in preparation for its opening and for hiring phases to follow. North Dakota is among the fastest growing states in the country and is consequently experiencing a rising demand for healthcare services. At the same time, North Dakota is among states which struggle to attract and recruit staff.

The facility’s hiring goal was aggressive, a total of 200 RNs (all direct hire) over the course of three years. Most all positions were in the Med-Surg specialty in addition to L&D and PACU.

Recruitment Strategy

Due to the high volume of hiring, it was important to develop a recruitment plan which would allow for consistent results, while achieving optimal staffing levels according to anticipated staff to patient ratios.

FocusOne recommended staffing in phases so ample time for onboarding and onsite training would be provided. Contingent staff would be utilized to support staffing levels and phase out over time as direct hire staff came on board and became fully acclimated.

To maximize efforts and optimize resources, FocusOne worked in conjunction with the facility’s Human Resources team to source staff. FocusOne concentrated on regions outside of the facility’s existing recruiting scope to identify qualified candidates in neighboring states and on the coasts. With a vast agency network and the ability to screen a high volume of profiles, FocusOne was able to expand the facility’s candidate reach and source staff they otherwise would not have acquired. In the process, FocusOne was able to alleviate pressure placed on the HR team in all points of the cycle.

Beneficial to the recruitment strategy was the facility’s openness to hiring new and recent graduates for Med-Surg positions, the bulk of the need. L&D and PACU positions required RNs with experience.


Over the course of the recruitment campaign, FocusOne screened a total of 580 candidate profiles. FocusOne placed a total of 115 RNs in direct hire positions, enabling the facility to open as planned with sufficient staffing levels. Of the RNs hired, the majority were recent graduates in Med-Surg positions. Recruiting was paced so as not to flood units with new graduates all at one time.

Placements by FocusOne

2016: 15

2017: 53

2018: 47

Most of FocusOne’s placements came from the western states of Montana, Idaho, and Southern California. Others were sourced from northern states, New York, Michigan, and Wisconsin. Recruitment was particularly effective in California due to the state requiring RNs with experience. This made the opportunity in North Dakota more attractive to new graduates.

Contingent staff was utilized to allow the facility to properly train new core staff. As direct hire staff increased, the number of contract staff decreased, meeting the facility’s overall goal to decrease use of contingent staff from 150 to 25.

The results of the partnership were highly successful. The majority of staff hired were retained for the long-term, the facility is operating at optimal staffing levels, and it has since maintained a strong retention rate.

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