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P067
Managing the Revolving Door: Orientation and Retention Strategies for an Ambulatory Care Subspecialty Clinic
Learning objectives: Analyze barriers/challenges and assemble a structured orientation to transition to practice for nurses in an ambulatory care setting.
Purpose: Proper onboarding and orientation are essential to building and retaining employees, as well as high-performing teams. The ambulatory care subspecialty clinic staff members are challenged with managing specific health concerns and conditions for the pediatric patients who present to the clinics daily. As a result, staff members working in these clinics require proper integration and transition into practice. Allen (2016) states, “Creating a core RN orientation program template is paramount for the transition of the RN to the ambulatory setting.” Therefore, a structured onboarding and orientation process is imperative for new, transfer, and contract employees working in the ambulatory care setting.
Description: Due to a turnover rate of 35.71% in the first quarter of fiscal year 2023, it was identified that the onboarding and orientation process was inconsistent and unstructured. In collaborating with the nursing leadership team, clinical educator, and a new position titled nurse retention specialist, we explored options that would enhance the employees’ onboarding and orientation experience. This caused an examination of how effective the orientation and onboarding program was in retaining talent in this outpatient department.
Outcomes: Studies demonstrate that a well-designed onboarding and orientation program can dramatically improve readiness, performance, and retention. Strategies used include the implementation of structure and process changes, such as a single centralized education resource for onboarding oversight, manager/leader cascading responsibilities, structured process map for onboarding and orientation, and use of interdisciplinary content has resulted in positive outcomes. Additionally, new focused orientation competencies include defining a healthy and safe work environment, role ambiguity and socialization while also handling role conflict, enhancing the Magnet® connection, building upon the management link to practice, and clarification of job expectations.
With every percent change in RN turnover, organizations can save approximately $380,600 per year. The orientation restructure proved a positive influence on the retention financial metric significantly. We anticipate turnover will decline allowing for the improvement of the bottom line, a more connected culture among clinic staff, and a seamless onboarding experience. Since January 2023, there have been zero nurse terminations in the ambulatory care subspecialty clinic, furthering the stabilization and validating the new processes. As other elements of the onboarding and orientation process are addressed, the hope is to sustain the program and transform and enhance the ambulatory care staff’s experience, knowledge, and skill during the onboarding and orientation process.
Purpose: Proper onboarding and orientation are essential to building and retaining employees, as well as high-performing teams. The ambulatory care subspecialty clinic staff members are challenged with managing specific health concerns and conditions for the pediatric patients who present to the clinics daily. As a result, staff members working in these clinics require proper integration and transition into practice. Allen (2016) states, “Creating a core RN orientation program template is paramount for the transition of the RN to the ambulatory setting.” Therefore, a structured onboarding and orientation process is imperative for new, transfer, and contract employees working in the ambulatory care setting.
Description: Due to a turnover rate of 35.71% in the first quarter of fiscal year 2023, it was identified that the onboarding and orientation process was inconsistent and unstructured. In collaborating with the nursing leadership team, clinical educator, and a new position titled nurse retention specialist, we explored options that would enhance the employees’ onboarding and orientation experience. This caused an examination of how effective the orientation and onboarding program was in retaining talent in this outpatient department.
Outcomes: Studies demonstrate that a well-designed onboarding and orientation program can dramatically improve readiness, performance, and retention. Strategies used include the implementation of structure and process changes, such as a single centralized education resource for onboarding oversight, manager/leader cascading responsibilities, structured process map for onboarding and orientation, and use of interdisciplinary content has resulted in positive outcomes. Additionally, new focused orientation competencies include defining a healthy and safe work environment, role ambiguity and socialization while also handling role conflict, enhancing the Magnet® connection, building upon the management link to practice, and clarification of job expectations.
With every percent change in RN turnover, organizations can save approximately $380,600 per year. The orientation restructure proved a positive influence on the retention financial metric significantly. We anticipate turnover will decline allowing for the improvement of the bottom line, a more connected culture among clinic staff, and a seamless onboarding experience. Since January 2023, there have been zero nurse terminations in the ambulatory care subspecialty clinic, furthering the stabilization and validating the new processes. As other elements of the onboarding and orientation process are addressed, the hope is to sustain the program and transform and enhance the ambulatory care staff’s experience, knowledge, and skill during the onboarding and orientation process.
Learning Objective
- After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.
Speakers
Monica Banes, MSN, RN, CPN
Director for Ambulatory Care Services, Texas Children's Hospital
Sherry Grant, MSN, RN
Specialties
General
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