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CHL Lesson Plans provide members with ongoing education focusing on supervisory or management issues. These lessons are designed for CHL re-certification, but can be of value to any CRCST in a management or supervisory role.

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Lesson Plan CHL 321
Off to the Best Start: Employee Onboarding (Part II)
[Reprinted from Communiqué: September/October 2010]

The first part of this two-part series defined “onboarding:” the process by which a new employee is welcomed and integrated into an organization. It also discussed the importance of providing positive first impressions for new staff members and reviewed some best practices for the new employee’s initial day on the job. The lesson concluded with a discussion of benefits of an effective orientation program and an explanation about how to plan and conduct orientation activities.

In this lesson, we’ll continue our close look at new employee onboarding procedures by discussing departmental induction and important follow-up activities.

The Induction Process

Many healthcare facilities consider orientation and induction to be the same process: informing new employees about their employer and workplace and position responsibilities. However, two separate programs must be planned and implemented so, therefore, it is easy to make a distinction between the two activities:

• Orientation is the process of providing basic information about the healthcare facility that must be known by all staff members in every department. It provides an initial on-job experience that helps new staff members become aware of the organization and its purposes, comfortable with the work environment, and knowledgeable about where and how they fit into the facility’s organizational structure.
• Induction relates to the process of providing new employees with basic information that everyone in their department must know that is unique to their department.

The distinction between orientation and induction programs is important. For example, everyone in the healthcare facility must know about compensation policies and procedures and the importance of serving the patients. This information should be part of the orientation program. However, perhaps only Central Sterile Supply Department (CSSD) personnel must know about process workflow in the department, the location and policies for use of the employee locker room, and emergency evacuation procedures from the departmental area.

New employees should ideally begin work in the CSSD when there is time for an organized and orderly induction. Contrast this with the unfortunate situation that often arises when a new employee begins work during a busy shift and is expected to almost immediately begin to assist with simple work tasks. Part One of this two lesson series emphasized that the new employee’s initial at-work experiences influence his or her perception of the new position, the department and the healthcare facility itself. An unplanned induction program can quickly destroy the benefits gained from an effective orientation program.

Which concerns can be addressed in an induction program? Figure 1 presents a checklist of possible activities.

The induction activities are not typically a sequential process in which initial training begins only after induction ends. For example, it may take several days or longer for a new employee to meet all CSSD staff members, especially if one or more are on vacation or on leave. As well, visits to operating room suites may be scheduled after training begins. Additionally, some healthcare facilities offer follow-up orientation sessions after the new staff member has been on the job for several weeks or months.

While it is relatively easy to design and check off items on an induction checklist, some absolutely critical requirements cannot be addressed in this manner. For example, consider the “human” side of induction. While introductions to staff member peers are easy, what about the process that is important to help make the new employee become an effective member of the CSSD team? Managers can say, “Be nice to the new employee,” but the development of the desired relationship between the two peers cannot be mandated. When the culture of the CSSD emphasizes respect for the employees (and this responsibility begins at the highest departmental levels), staff members are more likely to work together cooperatively as a team. When the leader is a good role model and helps employees find pride and joy in the workplace, the staff members, in turn, are more likely to have an attitude that recognizes and appreciates the spirit of genuine welcome and hospitality. When this is the case, they will want to greet the new member just as they would like to be greeted, regardless of a supervisory mandate or a job description requirement.

It is interesting that onboarding activities can be implemented and its benefits realized without great or, probably, even any additional expense. This, in turn, suggests that there are few practical limitations to work against its effective implementation. With that said, it is also interesting that, in most healthcare facilities, the highest levels of employee turnover occur with those who have been on the job for only several months. This suggests that either an improper selection decision was made, and/or that the initial on-job experiences were disappointing. Now for the good news: CSSD personnel can utilize a low- or no-cost process to reduce expensive employee turnover rates and ensure that initial on-job experiences create positive first impressions!

Post-Induction Activities

The implementation of facility orientation and departmental induction procedures such as those discussed in the two lessons in this series, may involve more time and effort than is spent by some healthcare organizations. However, as you’ve learned, a comprehensive onboarding program yields an effective employee adaptation process and committed staff members.

Follow-up activities are important. It is not sufficient to say, “If you have any questions, just ask someone,” or “Just assume you’re doing okay unless someone tells you differently.” New staff members should understand that the training programs in which they will be participating are going to be well-organized and delivered to help ensure they can perform required job tasks in a manner that will meet performance standards.

The person(s) who will provide on-job and/or other training to new staff members may or may not be the same persons who have participated in the earlier orientation and induction activities. Use of the same persons is more common in a small facility, and one advantage is the opportunity for continuity as the orientation-induction-initial training activities evolve. When different staff members are involved (more likely in a large facility), those who facilitated the earlier orientation and induction activities can, at least, serve as an “unofficial” mentor and offer genuine enthusiasm and provide follow-up assistance, as requested. They can regularly check back with the new staff member and answer questions and provide support, as needed. In effect, they become informal leaders who can help assure that the desired relationship between the facility and the staff member continues long after the orientation and induction processes conclude.

Some additional onboarding best practices that may continue for several (or more) months include:

• Ensure that the genuine concern and attention paid to the new employee continues beyond orientation and induction.
• Delegate slowly and carefully, and recognize that it is the supervisor’s responsibility to assure that the new staff member is prepared to take on additional work tasks. Note: over-employment (the notion that employees are doing more than they are able to do) is just as much of a concern as is under-employment (the concept that employees are able to do more than they are doing).
• Confirm that the job tasks performed by the new staff member are in line with those that were explained when job descriptions were reviewed during the earlier recruitment process. There should be no surprises about job tasks that the employee was expecting to do when the job commitment was made and the tasks which he or she actually does on the job. Except during emergencies, there are probably few times when a job description task that specifies “additional duties as assigned” is appropriate. Sometimes the presence of this statement in a job description suggests that there has not been careful consideration of work responsibilities for a position and, instead, the writer is afraid of omitting something that those working in the position are expected to do.
• Learn from new employees. One way to improve the orientation and induction programs is to obtain information from the new staff members about it. What did they think of the facility and the department when they first began? How, if at all, have their perceptions changed? What suggestions do they have about improving the first day, orientation, induction, and/or ongoing activities directed at assisting new staff members to successfully acclimate to their new jobs?

Some Final Thoughts

Significant costs can be incurred to employ new staff members. These include those applicable to recruitment and selection, and to providing the necessary training to enable new staff members to consistently meet quality and quantity requirements.

While these costs can be difficult to measure, they do exist. Effective onboarding programs can reduce high employee turnover rates. As this occurs, there will be lowered costs to orientate, induct and train replacement employees. The costs required to increase the productivity of new staff members will also be lessened.

You’ve learned that these early on-job experiences are important for the employee and the organization. Employees will, one way or another, learn about the facility, their position and their employer’s expectations. It is better for them to acquire this information through formal, planned, organized, and hospitable orientation and induction efforts than to learn in casual conversations with and by watching peers on the job. When effective onboarding activities are used, positive first impressions will occur, and they will contribute to positive ongoing impressions that will help a new staff member become a valued long-term employee.

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