Building an approach to RCT onboarding

Developing a Standardized Onboarding ProcessLauren Brischke

Agenda

• Overview• Methodology • Results • Recommendations

Project Overview Objective• Recommendations for improving the onboarding process for new

RCTs • Creating a standardized process for bringing RCTs onto their assigned

Living Units after CIP training

Overview

• Onboarding is an important part of overall retention strategy • Inconsistency in onboarding processes across living units leads to

variation in RCTs experiences• Re-evaluating this process will help build a more structured approach

The Revolving Door • “it’s like a revolving door—we are just making clones that come and go”• High turnover rates and vacancies for RCTs• Onboarding is one way to address new-hire turnover rates • Answers question “how can we keep the revolving door from spinning out of

control?”

38%

16%

15%

11%

8%

5%

4%3%

Percentage of Employees

RCTLPN/Other NursingMedical OtherBuilding/Maintenance Office/Administrative Food ServicesRCS

Classification

Methodology • Interviews• UD’s, RCS’s, and Job Coaches to learn about current process

• Focus Groups –to gain opinions • New RCTs and preceptors

• Survey • For New RCTs • Evaluated the impact of onboarding practices on comfort level

• Literature Review • Research best practices from other leading organizations

#1 Supporting Evidence:

    

Key Result : Some living units currently apply some very positive onboarding practices.

Best Practices Summary Table Table 1.3. Best Practices at CWC Summary Table

Onboarding Activity Best Practice Pre- Transition

Preparation

UD Introductions/ Unit descriptions in NEO Exposed to living unit before transition in training

 Introduction Meet UD on first day Meet all team members

Tour Informal introductions during tour Unit-Based Training exposed to each apartment/shift

 RCT Role & Expectations

Talk in depth with nurse, psych, etc. review job expectations

Socialization Use a welcome board  Preceptor Program RCS collaborates with preceptor

 Evaluation/Monitoring UD check in with new RCTs on daily roundsRCS, Job Coach, UD role RCS works side by side with RCTs

job coaches check in in the first few weeks UD participates in the process

Survey Findings

Correlation Analysis

Best Practices correlate with confidence/knowledge levels in first week/first month

• Opportunity to meet Senior leaders (.42)

• Job coach there to answer questions (.58)

• Unit-Based Training(.64)

#1

Recommendation: Apply the best practices used by some units at the center to other units.

Action Steps:

(1)Include best practices in the new employee toolkit as part of checklist (2)Set reoccurring agenda item for a current meeting to share best

practices, knowledge, experiences

Key Result : There is no systematic, structured approach to onboarding across living units. #

2 Supporting Evidence Focus group theme: need increased consistency

Variation in terminology, perceptions of roles, and levels of involvement Survey: Variation in information RCTs want more of

   

 

“It’s not consistent center -wide—we want consistency.”

Policie

s & R

ules

Roles/expectatio

ns

Annual Revie

ws

Organization G

oalsDLP

Livin

g Unit

Culture

0%10%20%30%40%50% 45% 45%

15%25%

20% 20%

5%

Please indicate the topic(s) you would have liked more information about.

Topic

Per

cen

tage

of R

CTs

Recommendation: Develop a comprehensive new employee toolkit that includes checklists and a written onboarding timeline.

#2 Action Steps:

1. Create a new hire checklist for supervisors

2. Include

a. Logistics information

b. Specific onboarding timeline

c. Roles & Responsibilities

d. Key skills list

EX: Consistency, teamwork, communication, helpful

e. Advice

EX: “Don’t rush or get overwhelmed “Observe how other RCTs react", "Carefully read DLP”, “Get to know people’s names fast”

3. Communicate to all members

4. Educate and train managers

5. Post resources electronically

Key Result : New RCTs experience an information overload during the transition from CIP training to their assigned living unit.

#3 Supporting Evidence:

 

    

Focus Group theme: need more time “There is lots of information, will probably take me the whole summer to learn”

“Already trying to retain a lot of information & DLP is not a small book”

“An extra week of working with another RCT would allow more time to absorb information”

“We need more time to get to know residents better”

“Too much information”

#3

Recommendation: Modify the time period RCTs have to learn unit-based information so it is longer and more participatory.

Action Steps:

(1) Create a realistic timeline (2) Increase hands-on experiences (3) Train employees on assigned unit

(4) Remind information over time

Pace delivery of onboarding information “it’s a marathon not a sprint”

Assimilated

Employee

Onboarding Length

Orientation Facilities

Orientation Paperwork

Company Handbook

Company Policies

Tour

Cultural

Mentor

On-the-job Training

Feedback Process

Key Result : There is no consistent approach to personal welcoming from key people.

#4 Supporting Evidence:

Survey data shows “I was introduced to my co-workers” received 87%

 

    

Focus group theme: variation in introductions

job coach was there tour of living unit

my unit welcomed me introduced to my co-workers

met with supervisor within weekopportunity to meet leaders

clear job duties and expectations resources I needed

someone was assigned assigned person welcoming

unit based training prepared me skills check-offs were used

feedback on my performance

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Please answer to following according to your experience: Yes or No

% of Respondants

On

boar

din

g A

ctiv

ity

“They may act welcoming, but sometimes not that welcoming” “there were no introductions”

#4

Recommendation: Speed the development of important working relationships for new RCTs.

Action Steps: (1) Managers welcome new employees their first day(2) Provide framework for socialization in assimilation checklist(3) Identify key people for new RCT to meet (4) Include leadership profiles that include photos(5) Prepare RCTs and others for productive conversations

a. clarify objectives of meetingsb. provide list of talking points

(6)Make formal and informal introductions (7) Invite new RCTs to key meetings (8) Conduct consistent check-ins with relationships

Preparation-prepare checklist-set up meetings

- brief bios, background

Delivery -

formal/informal introductions

Follow-Through-check in

consistently

Key Result: There is an opportunity to improve the understanding of the preceptor role and responsibilities for both the new RCT and the RCT preceptor. #

5 Supporting Evidence Survey indicates RCTs want to learn more information about roles/expectations

    

Policie

s & R

ules

Roles/

expectatio

ns

Annual Revie

ws

Organiza

tion G

oalsDLP

Livin

g Unit

Culture

0%

20%

40%45% 45%

15%25%

20% 20%

5%

Please indicate the topic(s) you would have liked more information about.

Topic

Per

cen

tage

of R

esp

ond

ants

• Focus group commentso “It was kind of scary; I was new and training right away and it was different”o “RCTs look at it like an ‘easy day’ or ‘rest day’”

• Survey: preceptor contributes most to onboarding experience  

Preceptor Introductions Unit-Based Training

Feedback Other0%

10%20%30%40%50%60% 52%

13%

48%

30%

4%

Which activity contributed the most to your experience starting to work on the unit?

Onboarding Activity

Per

cen

tage

of R

esp

onse

s

Recommendation: Create a more structured preceptor program. #5

Action Steps: (1) Recruit voluntary preceptors (2) Educate preceptors about role and responsibilities (3) Have consistent preceptors

(4) Develop and communicate clear expectations (5) Preceptors collaborate with the RCS

(6) Preceptor and new RCT should remain together(7) Increase recognition (8) Monitor Preceptor Performance

Key Result: There is no consistent process owner(s) for the onboarding program that integrates the activities of stakeholders or holds them accountable.

#6

Supporting Evidence:No consistent ownership of specific activities

“most of the time this person does it” or “when I am here this is what happens-but I don’t know about when I’m not here”

Interview “there is no point person for the whole process—who is going to help them when they get onto the unit?”

Variation in levels of responsibility associated with rolesEX: job coaches providing reminders to a “variety of roles including coach, parent and others”

Recommendation: Increase accountability for the onboarding process by establishing an owner of the whole process and defining who controls various steps.

#6

Action Steps: (1) Identify a process leader(2) document key roles, responsibilities (3) Increase leadership involvement

Survey: largest correlation for confidence in first week is “the opportunity to meet senior leaders”

Key Result: There is an opportunity for better preparing new RCTs for working with individuals at CWC.

#7 Supporting Evidence:

Survey responses: • Unit-Based training on all apartments• Train in assigned living unit• Increase interaction with residents in assigned building

 Focus group themes

Transition is overwhelming“Hectic, shocked, never knew a G-tube existed”

“Stressful and felt rushed, behind and frustrated”

“There was a lot of frustration, just kind of thrown out there”

Training isn’t realistic “Once on the units it was different than the way to pass certification”

“Should train on each apartment evenly so you get comfortable going to all apartments”

“If you work the way they teach you, you won’t get anything done—especially bathing”

#7 Action Steps:

(1) Have workforce SMT develop a multidisciplinary team

including leadership, Unit Directors, and other relevant employees

(2) Identify content areas to include in Unit-Based Training• Active Treatment• Remind of NEO content • Emphasize CWC guidelines and policies

how to get acclimated and how its different than CIP training

(3) Evaluate variables such as:• time requirements of new RCTs • how consistent training can be made across units

(4) Develop an improvement plan to modify Unit-Based Training

Recommendation: Expand Unit-Based training to better prepare new RCTs for working with individuals at CWC.

Key Result : There is not a performance evaluation system for the onboarding process.

#8 NEO evaluations but no follow-up after NEO

No measures of the long-term impact of onboarding activities

Recommendation: : Seek further feedback on onboarding program from new employees

Action Steps:

(1)Identify Process measures (were they introduced, was a checklist used)

(2) Identify Results/outcome measures (reduced turnover, increased retention/confidence)

(3)Monitor onboarding program effectiveness over time

Key Takeaways & Guiding Principles

Importance of applying best practices

Increase accountability

Increase consistency

Support implementation

Everything Matters: bring greater attention to each and every aspect of onboarding process

Little things make a big differenceChecklist, introducing yourself

Any Questions or Comments?