This article is an excerpt from Hiring and Onboarding Process Guidance. Search for the full guidance document by signing into our Resource Library.
As the world regains its footing around the COVID-19 pandemic, employee shortages remain rampant across many industries, but especially in the medical community. While the urgency to get professionals in place to help serve patients might tempt organizations to rush the process of orientation and onboarding, taking shortcuts in hopes of jump-starting productivity is not worth the potential risks.
Orientation focuses on paperwork, training, compliance, protocols, and procedures. Onboarding focuses on helping new hires create connections with people in your organization during their initial days at work and throughout their employment. Effective onboarding is a journey that takes the employee from orientation to integration to achieving productivity.
Without an organized and reliable orientation process, you increase your risk exposure in multiple ways, including through:
- Inefficiencies in care provided
- Potential increases in claims, due to lack of knowledge of procedure and policies
- Increased employee turnover
- Barriers to the defense of claims, due to gaps in education during orientation
In business, a standardized orientation/onboarding process assumes that all candidates start at the same place. In healthcare, this may not always be true. Depending on the individual experience or role the candidate was hired to provide, the onboarding process may vary. Employers’ understanding of what new hires already know or have been screened for and what they need to know helps expedite the narrowing of the skills gap through targeted training.
Depending on the size of your organization and the role of each person requiring onboarding (e.g., employed vs. contact worker, volunteer, student), this process can be organized in numerous ways. For new employees it is important that the HR Director/Clinic Manager encourages active dialogue. You may be onboarding one employee or an entire group, and onboarding procedures may be for the same/similar positions or for totally different positions/departments. Every employed staff member needs a general orientation that covers the following topics:
- Company history, products/services, management structure, and philosophy
- Company rules and regulations (e.g., absences, use of phones, parking)
- Orientation period (avoid terms probationary period and permanent employment)
- Pay schedules (including timecards or timesheets)
- Hours of work and overtime policies
- Leave time (e.g., sick days, holidays, vacations, legally mandated leave)
- Employee benefits and eligibility (e.g., health insurance, disability insurance, life insurance, pension, educational assistance)
- Completing tax, insurance, and other forms
- HIPAA training specific to your organization
- Company policies on discrimination, harassment, and retaliation; what to do if the employee has a complaint or concern; and code of conduct
- Diversity, equity, inclusion, and implicit bias
- Requests for accommodation due to disability or religion
- Employees’ responsibilities in the event of an internal or external disaster
- Key safety content (bomb threats, active-shooter drills, fire safety and response, emergency responses)
- Location of the employee handbook (e.g., binder, paper copies, electronic copies, policy and procedure system)
Contract workers, agency staff, and volunteers may require only some of the information listed above. However, it is important that they receive most of this information from orientation, excepting, e.g., inapplicable pay and benefits information.
After the general orientation, conduct a combination orientation/onboarding session that is specific to the employee’s role in their department. This may start during the formal orientation process, or it can take place when they are formally transitioned to the oversight of their manager/supervisor. Include information that is important for everyone working at your organization:
- Identify the employee’s main contact(s) for job-specific orientation/asking questions on the job
- Give a tour of the department, an introduction to coworkers, and a review of locations of code carts/kits/defibrillators
- Review job description and collect signatures
- Review department responsibilities
- Review infection-prevention practices
- Go over company policies on discrimination, harassment, and retaliation and what to do if the employee has a complaint or concern (if not already addressed)
- Give information concerning safety rules and emergency exits—including the different color codes used for overhead paging—and what to do in case of fire
- Provide details concerning housekeeping, including where to locate MSDS safety information; lunch and break provisions; location of restrooms, lockers, lunchroom, etc.; how to get tools and supplies; and equipment orientation
- Review key policy and procedures, specific to positions (e.g., for nursing: medication administration, handoff protocols, patient rights) and where to find them (e.g., third-party software, binder, shared drive)
- Collaborate on and review employee goals
Orientation and Onboarding Documentation
Be sure to fully document the orientation and onboarding process, including for contract workers, agency staff, and volunteers, so that the information and training provided can later be proven. Clearly outline and collect copies of forms/documents that require acknowledgement. Retain rosters of educational presentations, as well as the presentations themselves. Maintain all policies, including their prior versions. Checklists or computer software can help keep this process organized and allow for quick identification of outstanding items. Checklist examples, such as the Assistant Secretary for Preparedness and Response (ASPR TRACIE) Healthcare Facility Onboarding Checklist, can be found online.
The importance of implementing onboarding processes cannot be overstated. Investing in these programs will strengthen your bottom line and protect you from risk exposures, including barriers to the defense of claims due to gaps in employee orientation.
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