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Nursing recruitment

Errors in your onboarding process can be costly

BY: Elise Oberliesen on August 22, 2018

Most of you already understand the value of sound onboarding processes with new hires is part of the day-to-day realm of good HR practices.onboarding process

The onboarding process includes providing forms for health benefit coverage and setting up payroll, email accounts and security badges.

But when healthcare facilities practice sloppy onboarding — such as an absent boss on a nurse’s first day or forgetting to explain key job responsibilities — it can create a poor initial experience that affects employee retention, according to experts.

A survey about onboarding by CareerBuilder.com suggests 49% of employers fail to summarize processes around how things work, followed by a lack of ongoing employee training at 45%. Employers also need to introduce new hires to key players while they integrate them into workplace culture when onboarding new nurses.

Leaving so soon? But you just arrived!

What happens when the onboarding process repeatedly goes awry? Those healthcare organizations may develop a bad reputation. It’s called poor onboarding — which happens when organizations fail to properly integrate and train new employees.

When hospitals continually experience rapid turnover, it could be a direct result of poor onboarding processes.

Left unchecked, turnover also can lead to a cascade of unintended consequences, said Dan Ryan, principal with Ryan Search, a talent acquisition company based in Nashville, Tenn.

He said nurses know right away whether they will have a love or hate relationship with their new employer — especially with a poor onboarding experience.

Planning their escape route happens sooner than you might think. It’s not uncommon for nurses to leave the job within six months if they’ve experienced a negative onboarding process, he added.

“People often make the decision to leave in the first month, and often the first week,” added Kim E. Ruyle, president of Inventive Talent Consulting, based in Melbourne, Fla.

First, the nurse disengages from the job and employer, followed by updating his or her resume, then actively seeking out new employment options, Ryan said.

Patient care can suffer, too

When a healthcare facility ignores its turnover problem, it may also put patients at risk, Ryan added.

“Nursing is about protocol and not everyone’s protocol is the same,” Ryan said. “If you have significant turnover, mistakes will occur because the [temp or new hire] won’t know these protocols very well.”nurse turnover rates

Another risk associated with high turnover is patients might not come back because of poor service or inattentive staff, Ryan added. It’s no different than getting a bad enchilada or overdone steak at a local restaurant. Bad food and service sends customers away.

“Turnover is strongly correlated with decreased patient satisfaction,” Ryan said.

It happens when nurses become disengaged employees because they start to care less about the job — and the people — including co-workers and patients.

“The more disengaged they are the greater the negative performance they will have and the greater negative impact on patient satisfaction, like how well a nurse will listen to the patient or how fast they respond to patients,” Ryan said.

The organization’s bottom line suffers too because of the opportunity costs that go into finding replacements when nurses leave. Turnover accounts for one-and-a-half to three times the nurse’s salary, considering all the effort required to re-recruit for unfilled positions, Ruyle said.

“You are paying overtime for people to fill a hole which represents an opportunity cost,” Ruyle said. “Plus the disruption in the workplace that negatively impacts productivity and performance [of other nurses].”

Ruyle said health organizations pay a hefty price to exit employees, but an even greater price to recruit and onboard new employees.

When an organization develops a poor onboarding reputation, former employees are less likely to refer to it as a desirable workplace, according to a recent survey by Digitate, a Santa Clara, Calif.-based company that provides IT automation and artificial intelligence technology.

The survey found one in five new hires are unlikely to recommend an employer to a friend or family member after a negative new hire onboarding experience.

job application process

Automation creates more consistent onboarding processes

Fixing a poor onboarding problem sometimes can be solved by automating the onboarding process.

More than 40% of HR managers who do not capture onboarding information electronically spend three hours or more per new employee manually collecting and processing onboarding information that could be automated instead, according to the CareerBuilder survey.

When HR departments automate their onboarding process, many report significant time savings as a result, said Jayanti Murty, chief technology officer at Digitate.

“You can eliminate a lot of manual processes that tend to add latency, which can be done in minutes to hours,” he said.

Automation reduces redundant tasks, such as filling out duplicate forms, and it brings together necessary staff across multiple departments who provide authorizations or permissions, like access to patient electronic health records.

“Automation breaks down silos (departmental) and creates a single-step process that happens in the background,” Murty said.

For example, the IT department handles access to computer systems and security allowances while HR handles health benefits and payroll. Automation supports cross-departmental operations so each department has access to employee information, which results in a speedy onboarding process, Murty said.

While it’s difficult to pinpoint an exact savings in revenue by implementing automation, the savings are significant, Murty said.

“The automation benefits vary from 25% to 55% improvement in productivity that leads to savings of millions of dollars,” he said.

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Elise Oberliesen

Elise Oberliesen has 15 years of combined media and marketing experience. Her work appears on corporate blogs and publications, such as the LA Times, Chicago Tribune and AARP. Her specialties include healthcare, high tech and finance. Elise is a member of the Association of Healthcare Journalists and founder of Big Mountain Media.