IHS Retention Briefs | Volume 3 — Issue 5
June 2016
Photo of Employees

“Rural clinicians are often geographically isolated and experience less-than-average contact with other professionals who could provide education, camaraderie and
back-up support.”

Onboarding: Building a Strong Support Network

The IHS Office of Human Resources (OHR) Division of Health Professions Support (DHPS) is pleased to bring you the fifth eNewsletter in our Retention Briefs series for 2016. This issue continues our series focused on onboarding new employees. As we noted last month, onboarding is a structured plan that helps a newly hired employee adjust to the social and performance aspects of his or her new role.

Why onboarding is so important: Well-designed and well-executed onboarding programs can reduce turnover by up to 25 percent,1 increase productivity and improve communication among staff members. Since an average of 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 population.2 Keeping clinicians in your facility will enable community members to achieve their best possible health status.

Lack of Support: A Key Barrier to Retention

Many clinicians cite three reasons for their desire to leave a rural health care facility: lack of support from the community, unreasonably high demand without professional backup and professional isolation.3 Physicians in particular work much longer hours in rural facilities due to the nearly constant on-call hours. In addition, it is difficult for rural providers to get much-needed time off, including vacation, maternity leave and time to attend professional conferences.

Rural clinicians are often geographically isolated and experience less-than-average contact with other professionals who could provide education, camaraderie and back-up support. A successful onboarding program can promote the development of a support network inside the facility to reduce feelings of isolation and outside the facility to establish professional contacts in the area who have similar fields, specialties or interests.

When all is said and done, the health care providers you hire have a tremendous and positive effect on patient health, as the individual patients develop confidence and trust in them and are more receptive to and compliant with treatment recommendations and requirements.

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.

3 Nestman, NA. Retention of Physicians in Rural Areas: The Case of Nova Scotia, 1998.

Top Reasons for Leaving a Job

Note: Respondents could choose more than one.

Source: Accenture Survey, 2013 .

Onboarding Case Studies

Each onboarding is as unique as the individual you’ve hired and communication is key. Here is the second in our series of case studies to portray a variety of onboarding situations to help you welcome new hires to your facility and avoid negative outcomes.

Case Study

Social Worker — Small Community Hospital in Bemidji Area

When Mary interviewed for a social work position at a rural Tribal facility in the Bemidji Area, she was initially hesitant to consider the role because she had always lived in large cities. After the interview, her hiring manager introduced her to Janet, an RN who also worked in the facility. Janet gave Mary a tour and invited her to hike on a local trail, where they talked about all of the recreational activities nearby.

Mary accepted the position and soon received a welcome package and list of benefits. She also received an email from Janet, inviting her to a welcome lunch on her first day of work.

Once she started, Mary’s hiring manager checked in regularly to see if she was able to meet the goals they had agreed on and if any particular barriers existed that might prevent Mary from meeting her goals.

At her six-month check-in with the Clinical Director, Mary mentioned that the in-home visits Janet had arranged with several families had been especially useful in understanding her patients. She suggested additional resources; the Clinical Director told her which could be provided immediately and which would take more time to arrange. They discussed other specific expectations and left the meeting with a clear path for moving forward.

Three years later, Mary says a career in Indian health is the best decision she’s ever made. She has built strong relationships with her coworkers and clients and feels she has become a member of the community.

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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