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How to leverage onboarding as a tool for staff retention in healthcare

Staffing is among the top concerns in business today, regardless of sector. In healthcare, adequate staffing is a particularly acute issue. At every level, healthcare professionals are exhausted. But a robust onboarding process is not only foundational to employees providing safe, reliable care, it’s also a key component of employee retention.

Onboarding must go far beyond first-day orientation. The onboarding process should include activities that connect a new employee to the organization more broadly—its mission, vision, and values—to their unit or department, and, finally, to their own professional development. For healthcare workers, every step along the way should foster a sense of belonging.

What motivates employees to stay at an organization? These retention prerequisites include liking the work, feeling that their work is meaningful, and knowing their work makes a real difference. Diversity, equity, and inclusion (DEI) is another must-have for most healthcare workers, and is closely linked to psychological safety. These nonnegotiables must be evident in all levels and all roles at an organization, from the C-suite to the front lines, across clinical and nonclinical staff.

How developing a sense of connection from day one contributes to staff retention in healthcare

Early on, new employees need to start building a connection to the overall organization. Some elements of this stage are the basics of onboarding. How do you reach HR? Request time off? Report a problem? And so on.

But answering those types of questions, which familiarize new employees with the organization’s systems and processes, is just the beginning. Getting face time between new hires and senior leadership during their first few weeks on the job helps employees feel like part of the team. Whether an executive attends the orientation or meets personally with individual departments, making sure that new employees feel welcomed by senior leaders is a crucial step in the onboarding process.

>> Related read: 5 key employee retention trends of 2022

Indoctrinating employees into the company culture and its mission is also integral to onboarding. At Cleveland Clinic, for example, everything is viewed through the lens of “patients first.” Explicitly stating what the organization stands for—then sharing examples of how that plays out in day-to-day operations—helps new employees understand what they’re working toward.

Ensuring new healthcare employees connect to the organization at the local level

We must bring the organization’s values to the department and unit level. For example, new hires might understand how to access HR, but do they know how to make a suggestion about the floor that they work on? 

One way leaders can do this is by aligning daily activities with the broader organization’s values, and then explicitly showing employees this alignment. For example, if a leading value is “safety first,” how does that impact daily assignments and decision-making within the department or unit? Tying the organizational values to the day-to-day activities of any given department or team requires consistent messaging throughout the organization. It helps everyone feel they’re on the same page.

In order to feel part of a team, employees need a way to contribute more than their labor. Introducing new employees to the feedback pathway is critical to making them feel they’ll be heard, and that they belong. If they have a suggestion for improving upon the status quo, they need to be able to share this information, and get it in front of the people who can effect change. A clearly defined method for providing workforce feedback is essential for a thriving work environment.

Equipping healthcare staff with individualized professional development

When it comes down to it, a person usually decides to stay or leave a position because of how they feel about the work. A mentor can be an ongoing point of contact to not only help with a new hire’s education and professional development, but also reinforce the mission, vision, and values of the organization through a one-on-one connection.

A mentor—someone to answer questions and offer insights—can be a lifeline for new employees. Organizations need to properly train mentors so they extend and reaffirm consistent messaging around the organizational values.

As early as possible, managers and other leaders should work with new hires to develop an individualized development plan (IDP). A development plan is helpful for the leader, the employee, and the organization. It ensures everyone involved is aligned on goals, how each individual’s goals intertwine with the organization’s goals, and how the organization can help the new hire achieve their personal growth and development goals. For example, if someone’s looking for a promotion within a certain time frame, that employee, their manager, and leadership must be aligned on the timeline, the role each will play in the process, and the steps needed to achieve that goal.

A key strategy to support the execution of individual development plans is a clearly stated and scheduled timeline for employee evaluations. Feedback sessions (or leveraging lifecycle surveys to capture voices) at 30 days, 90 days, and 180 days help the employee understand how they're performing—while providing an opportunity to give feedback on the onboarding process. Leaders can also assess the employee’s sense of belonging to increase the likelihood of retention, especially within those first 45 days.

Employees need to understand what will be covered during these feedback sessions so they can come prepared. What does individual success look like? How do they build upon strengths or work on areas for improvement? This allows for the employee and manager to direct productive conversations and set future goals.

From nurturing your organization’s culture to developing an attainable professional development plan, the thread between onboarding and retention can result in more engaged employees, a more efficient organization, and, ultimately, higher-quality patient care.

To learn more about employee retention, onboarding, and more, reach out to one of our staffing experts

About the author

Marty oversees the Experience solutions team in Strategic Consulting, partnering with clients to improve culture, employee and physician engagement, and diversity, equity, and inclusion. He drives improvement by reducing turnover, sustaining change, and develop tools and techniques to create an inclusive and equitable environment. Prior to joining Press Ganey, Marty was Vice President of Engagement Services at Avatar Solutions.

Profile Photo of Martin Wright