IHS Retention Briefs | Volume 3 — Issue 4
May 2016
Photo of Employees

“Keeping practitioners in your facility will enable community members to achieve their best possible health status.”

Onboarding: The First Best Step

The IHS Office of Human Resources (OHR) Division of Health Professions Support (DHPS) is pleased to bring you the fourth eNewsletter in our Retention Briefs series for 2016. This issue introduces our new series focused on the importance of “onboarding” — a structured plan that helps a newly hired employee adjust to the social and performance aspects of his or her new role.

On average, employees decide whether or not they will stay with an organization during the first two weeks of employment.1 By providing a comprehensive onboarding program as part of your staff orientation process, you will make a sound investment in the new hire’s long-term career, your patients’ access to care and the overall Tribal community’s health and welfare.

The onboarding process will enable new clinicians to quickly learn the attitudes, behaviors and culture relevant to your site, ensuring that he or she can begin making a significant contribution to your facility and the community.

Well-designed and executed onboarding programs can reduce employee turnover by up to 25 percent,1 create increased productivity and increase communication among staff members. Since, on average, 20 percent of health care workers leave their jobs each year, a successful onboarding program that improves retention can save your facility up to $100,0001 — the cost of replacing one experienced nurse. The availability of health care workers in an area contributes to the health outcomes of its population2; keeping practitioners in your facility will enable community members to achieve their best possible health status.

Sources: 1 Bauer, TN. Onboarding New Employees: Maximizing Success. Society for Human Resource Management Foundation, 2010.

2 Increasing Access to Health: Working in Remote and Rural Areas Through Improved Retention. World Health Organization, 2009.

Onboarding Case Studies

Every onboarding program has similar elements that make it successful, but it’s not an exact science. Each onboarding procedure is as unique as the individual you’ve hired — and communication is key. Continuously check in with your employees throughout their tenure and let them know that you both appreciate and need their ongoing service to your facility.

We’ve developed a series of case studies to portray unique onboarding situations to illustrate how you can welcome new hires to your facility and avoid negative outcomes. Here is the first; look for more in upcoming issues.

Case Study

Certified Nurse Midwife (CNM) — Small Community Hospital in a Rural Setting

As an American Indian, Cheryl grew up knowing that both she and her mother had been born under midwifery care and, as she entered college, she knew that continuing this legacy with other American Indian women was her calling. When she was offered a midwife position at a rural facility several states away from the rural area in which she grew up, she was eager to begin caring for the women and babies in a new community.

Prior to her arrival, Cheryl was paired with a community mentor who was also a midwife. Her mentor threw her a welcome party so that she could meet the retiring midwife whom she would replace and the other providers. In addition, the Clinical Director at the facility arranged a luncheon with Tribal leaders on Cheryl’s first day. This allowed her to learn the issues unique to the community early on. She began her orientation during her first week and was well-prepared to start her new position.

After three months, Cheryl had established a relationship with her manager built on trust and encouragement. She was honored for her work at her six-month and one-year anniversaries.

Now, six years later, Cheryl is a highly valued member of the facility’s staff and is beloved within the community.

Four Tips for Cultivating Future Health Profession Hires

Since they are in such high demand today, primary care providers are especially likely to be lured away from rural areas with promises of less work and more pay. Too many communities are faced with a sudden loss of a primary care provider and are not prepared to quickly replace him or her. Delays in recruiting a new provider can severely affect a community’s access to care and potentially place the entire rural health care system at risk because of diminished revenues and referrals. Even with a full complement of providers, it’s important for facility leaders to continue to cultivate relations with potential candidates. Here are some ideas:

  1. Become a rural training site for medical students, primary care residents and mid-level health care provider students.
  2. Stay in touch with these residents and students after they finish their rotation in your community and long into their careers.
  3. Encourage medical staff members to cultivate a rapport with potential candidates at Continuing Medical Education (CME) conferences.
  4. Bring in locum tenens (temporary coverage) providers who may be willing to consider permanent practice opportunities.

Source: Recruiting for Retention: The Manual. 3RNet (National Rural Recruitment and Retention Network), 2015.

OHR/DHPS Online Fulfillment System

The OHR/DHPS Online Fulfillment System is a fantastic resource for informative, up-to-date materials about the IHS Loan Repayment Program, Scholarship Program and all DPHS recruitment and retention marketing and advertising communication efforts. These materials (available in print and digital form) are available to order at no cost to you. To access a list of materials and to order, click here. You must create a username and password. Contact the administrator to set up your account.

In addition, you can also download materials from the Retention website.


Great Read

Organizational Onboarding: Setting the Stage for Continued Employee Satisfaction, Productivity and Organization Success offers all that you need to help newly hired employees adjust to their role, coworkers and an organization’s work environment and culture.

The policy of the IHS is to provide absolute preference to qualified Indian applicants and employees who are suitable for federal employment in filling vacancies within the IHS. IHS is an equal opportunity employer.

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