"If they have an email address of smokeemup@gmail.com on their resume, I'm not going to call," says Jennifer Neal, administrator with Pulmonary and Sleep Associates in Birmingham. "Obviously you're not thinking."

Red flags like these make trimming down the initial pile of resumes for a staff position at a healthcare facility easier. "If they only say the hire date on their resume, that tells me a lot," says Tina Davis, practice administrator with Surgical Associates of North Alabama in Decatur.

Davis, who oversees a staff of 14 and five physicians, says a recent hiring problem has been the lack of work ethic among the younger hires. "They're more interested in their phone or their social life. They don't have the initiative to do things on their own, to see what needs to be done and just do it."

To fill that skills gap, she began pairing younger new staffers with a mentor. "Someone on staff who has the experience to work with them and say here's what to do and why and how," Davis says. "But also to point out when you see this, go do that. To jump in and help without being asked."

Not only has it helped with task training and teaching initiative, but with melding them into the staff. "It gives the new person someone they can relate to right off the bat," Davis says, which helps with retention and staff morale.

Social media may cause distractions for staff on the job, but it can be revealing when hiring. "Avoid making assumptions in prescreening," Neal says. Bias and lack of context can create false scenarios in a hirer's mind and lose out on a potentially good candidate.

References can be equally biased. "Normally they give favorable reviews. But the reference may say enough between the lines that indicates they're probably not a good employee," says Greg Hulsey, CEO at Maynor and Mitchell Eye Center and Eye Surgery Center of North Alabama in Huntsville.

Asking the reference if the person is eligible for rehire can be the most telling. "People won't always answer that question, but sometimes they say no, and that's enough of a red flag," Hulsey says.

Everyone agrees the most effective tool in the interview is the behavioral-based question. "I want to know specific examples of situations they have been in on the job and how they responded," he says. "Not how they think they would respond to something."

The circumstances of the situation need not be in healthcare to be relevant. Hulsey had a candidate who had worked a bakery describe handling a disgruntled customer who destroyed their birthday cake while ranting at the counter. "The candidate talked about maintaining her composure, and working with the customer to get her a resolution on what she wanted," Hulsey says. "That gave me a lot of insight into someone who won't panic in a stressful situation. I hired her, and she still is in a management position and doing well."

Hulsey also likes to involve a peer or a doctor in the interview process. "It not only gives a sense of buy-in from the staff or physician in the new hire," he says, "but also involving a second person can give you insight into something you may have overlooked.

"If you want to have your doctors involved in your interview process, it's important you sit in on it or that you give them questions ahead of time. Then if they deviate in any way, you cut them off." Physicians not trained in interviewing can inadvertently ask inappropriate and unlawful questions, such as where someone goes to church.

The biggest hiring errors tend to derive from desperation. "Never hire someone simply to get a body in a position," Hulsey says. "If you make a desperate hire and that person doesn't work out, you will have to go through the same cycle again, which incurs costs for advertising and training the new employee."

Neal says that once she had been looking for months to fill a nursing position. One candidate interviewed really well. "She was fantastic. She'd just moved here and was a go-getter. Everything I needed, she had," Neal says. They hired her. "But something had bothered me that I couldn't put a finger on."

Six weeks later, the new nurse revealed she was pregnant and had the department of human resources visiting her for past issues with her children she had left behind in another state with an ex-husband. It took the advice of lawyers to be free from the desperate hire. "I should have trusted my gut, but I needed someone so bad, I hired her," Neal says.

As an alternative for administrators looking for help in hiring, Neal suggests using healthcare consultant firms. "Healthcare consultants that offer lots of different services--like billing and practice management--know what the criteria is for working in a healthcare office," she says. "I have had good experiences with them."

The healthcare consultants handle advertising, drug screening, background checks and at least the first round of interviews. "The candidate doesn't come to you before they've passed a series of steps, so it makes everything easier when you don't have time," Neal says.

No matter the hirer's experience, bad hires will occur and administrators should not give up on a good hiring process. "I don't think there's a process that's fool-proof," Hulsey says. "Sometimes you do all the things right and it still doesn't work out."