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Press Start: Lead an Empowered Life as a Clinical Laboratorian

Importance of Effective Onboarding

Published July 21, 2013 2:21 PM by Glen McDaniel

A few years ago I was part of a team appointed by a national hospital company to study and make recommendations for staff retention. The organization had a horrendous record for turnover; in fact in some key areas like nursing assistants the turnover rate was 40 percent!

Such a high rate was untenable because of its cost to the organization, but also because it directly affected patient experience (customer satisfaction), team coherence and clinical competence. There were always new staff members learning processes, procedures and trying to blend in. Current staff members were resentful of, and tired from, constantly orienting new staff, only to see them leave.

Our first charge as a team was to find out why staff were leaving at such a high rate. Surprising to many of us, the main reason was not low pay, lack of resources or even poor management. While those figured into the
equation, the one message across 60 plus facilities all over the country was that employees were leaving because they felt let down by the orientation process. They felt they were misled; somewhat like being conned by false advertising. Many felt that they were turned loose and expected to function before they felt

Onboarding is the first step in orientation. It consists of a series of steps aimed at integrating new employees into the organization. Although we did not study laboratorians as a separate group, the lessons learned can be applied to any professional group-and was successfully adopted in the organization.

First day orientation was revamped to be more of a "welcome to the family." We removed many of the heavier paper heavy topics and just initiated a conversation, introduced key members of the organizations and
answered questions of concern raised by the employee.

We also made the conscious choice to have employees guide their departmental and technical orientation.  Different employees have different needs. While we still had a structure and guideline about what should be covered and for how long, we would meet with employees regularly and seek feedback about progress, areas of concern and their comfort level.

Each employee was assigned a (trained) mentor-buddy whose role was to answer peer questions and facilitate movement through the department and organization. Questions could be as simple as parking, location of the cafeteria, who to contact in HR about a problem and who was the technical expert in the laboratory regarding a particular topic.

For two years we sought feedback from employees who stayed and did exit interviews on those who left. We asked what worked and what didn't. One big lesson learned was that the organizational culture was learned best by example and not by mission and vision statements delivered from on high at orientation, or hung on a wall.

Over 2 years the turnover rate for that organization dropped to 11 percent and employee satisfaction rose to the 95th percentile nationally. 

Turnover has tremendous costs to an organization (financially and morale-wise). In my experience, effective onboarding is one proven way to both reduce turnover and improve employee and patient satisfaction in a relatively short time. It's definitely worth the investment and returns a huge return on investment.


helllo !

terry August 14, 2013 12:00 AM
londin IN

I agree that orientation is the most valuable function an organization can do for its new members. Too many times labs and others spend time on recruiting and then they forget about employees.

I came from education before I went back to school to study lab. I must say we had the same problem there where school districts would pay signing bonuses etc and check credentials but many educators especially non classroom teachers would be on their own. They would be evaluated but very little was spent onboarding them to the district or the particular school.

This is a problem of lack of foresight in many professions I think.

Alfredo Pena August 3, 2013 6:06 PM
Dallas TX

Very interesting. I went to a seminar about 6 months ago and they talked about the use of perks and recognition to retain employees. They agreed that turnover costs a lot. But the emphasis was on giving stuff to keep employees.%0d%0a%0d%0aOne lady in the audience talked about how they had found that orientation helps a lot. She also emphasized the importance of asking employees what they want. That touched  a nerve in me. I mean it made me think about my own feelings and experiences and I agreed with her 100%.%0d%0a%0d%0aYour article just confirmed my feelings and also agreed with what that woman said. I think most of us managers miss that whole concept. Thank you very much.

Justina Farrell July 21, 2013 2:56 PM

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