Improving Your Staff Onboarding Process

Nena Hart, owner and executive consultant, Hart Healthcare Solutions

The staff onboarding process plays an important role in establishing a positive employee experience with your senior care organization from the start. But it’s all too easy to overlook essential aspects of a quality onboarding process, potentially resulting in mistakes that can harm staff preparation, retention, and more.

Whether you have a well-established onboarding process or are looking to better organize the process, it’s well worth investing time in improving your staff onboarding.

Why Quality Onboarding Matters

Your onboarding is your organization’s chance at a good impression, explains Bette McNee, RN, senior risk management consultant at Graham Company, and it’s also where many organizations go wrong. “If that first day you’re met with people who weren’t expecting you, who are scrambling, and who seem kind of surprised to see you show up, you not only feel unwelcomed, but also that you’re bothering their day. It really sets things off on the wrong foot.”

Nena Hart, MSN RN, CHPN, RAC-CT, C-DONA, owner and consultant at Hart Healthcare Solutions, notes that a poor onboarding process can lead to turnover and decreased staff retention rates. “Turnover right now is at a critical level, with people leaving the field,” she says. “I think that’s the most important thing to realize; an onboarding program can help you to keep your staff long term.

Challenges in Providing a Quality Onboarding Process

That’s not to say that it’s easy to offer an ideal onboarding experience. McNee notes that simply finding the time to invest in onboarding is a challenge for many organizations, particularly when they’re operating with reduced staff. The result can be that staff don’t have time to stop and really plan out the onboarding experience, and they may not be as organized, prepared, calm, welcoming, or relaxed as they would otherwise be with additional staff help and a reduced workload.

Hart agrees that having the manpower to execute onboarding at an appropriate level is a challenge for many organizations. “In theory, there may be a great idea behind the program, with a HR person welcoming staff, the business office manager buying them lunch, and someone giving them a tour.” But what often happens is there’s a critical need and the facility thinks they don’t have time for a full orientation and need staff on the floor to help; often, staff receive minimal to no training.

Creating an Ideal Staff Onboarding Process

According to McNee, the onboarding experience needs to start in the pre-onboarding period. “The time period from when a new employee accepts their job offer to their first day is such a missed opportunity for employers,” explains McNee. Employees who were considering multiple positions might be second-guessing their decision during this time, especially if there’s lack of communication from the senior care organization. If organizations reach out during that time, it’s often to request a physical, drug testing, or license information.

McNee suggests that organizations make the most of this time period by getting the employee engaged with the workplace culture before they even arrive. She notes that sending new employees swag, information about their first day, and more engaging correspondence is important. One of McNee’s clients has their current staff send a new employee postcards with messages about how they’re excited to meet and work with the new employee. “That’s what onboarding is all about – getting that person engaged in your culture,” she says.

When it comes to the actual onboarding, Hart suggests that organizations focus more on the culture of the organization and how it applies to everyday practice. “When you do that, it tells employees that you  enough to have goals, and it gives a united vision to how you want things to flow – even if things don’t always flow that way.” This approach sets expectations early in the hiring process that the organization wants to be the best and have a great culture.

She also highlights the importance of avoiding frustrating employees during their first day of orientation. Rather than putting employees in a single room for an eight-hour course, look for ways to create an exciting experience. She suggests finding a way to have orientees do part of their job on the first day by shadowing, so they get a sense of what their work will be like and they start to meet the people who they will work with. “Getting that engagement early on is really important,” she says.”

According to McNee, it’s important to get feedback from orientees about the process, too. “We don’t hire employees because they don’t have an opinion,” she says. “We chose them because they’re a good fit. Early on, engaging employees in giving us feedback is very helpful. It conveys how important they are and how much we care about what they have to say.”

She explains that it’s a mistake to only ask for feedback early on and then not check back for 90 days. She encourages organizations to get feedback during that initial onboarding period, but then to also check in as staff are on the floor, since they may identify differences in the classroom training they receive and how work actually takes place within the organization. “This engages that employee in the culture, and they understand that we do want to learn if things aren’t working right,” says McNee.

Hart notes many onboarding processes are missing a section on conflict resolution and how to critically think through problems. She suggests that organizations specify what steps new employees should take if they have a complaint. “What if my new supervisor puts me on the floor tomorrow, what’s the chain of command, and how do I resolve issues in the orientation that I have?” says Hart.

If new hires have problems during their orientation and already don’t have a way to resolve and address them, they might feel that the organization isn’t a good fit.

Best Practices in Evaluating Your Current Onboarding

That employee feedback can provide valuable information about your onboarding process, but McNee notes that “secret shopping” your onboarding can provide additional insight. Look for someone objective, like a sister community, who can evaluate the experience.

She also suggests that organizations look at the touchpoints they have during that early pre-employment period. “That’s a great place to engage that person before they walk in the door,” says McNee. “I think that’s probably the greatest missed opportunity.

Hart suggests anonymously surveying staff who have been with the organization for less than 90 days to learn about their experience with the orientation process. Most importantly, acknowledge their feedback and work to correct the issues that staff identify. If necessary, bring the survey results to corporate and explain the changes that you need to make to support your facility’s unique needs.

The more an organization can connect with and engage the employees, the better. McNee notes that when she first joined Graham Company, she found her name was already on her office door on the first day. “That had never happened before,” she says. “Something as simple as my training manual had my name on it.” Taking the time to think out the onboarding process shows that your organization truly values its employees, and that can make all the difference.

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.