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Achieving Nursing Excellence: Hiring and Onboarding

As hospitals and health systems continue to transition to a performance-based system, healthcare leaders are motivated to build the best care teams to serve their patients and families. The nursing workforce constitutes the largest segment in healthcare and can have a direct impact on patient outcomes. We know that retention in care teams can provide a more stable workforce and ensure continuity in the provision of safe and effective care.

Now, more than ever, hospitals and health systems across the U.S. are focusing strategic resources on retention and organizational learning and development to elevate the performance of their clinicians. As organizations continue to identify best practices, it will be essential to:

  • Build a sustainable model that supports the lifelong learning process throughout the clinician’s lifecycle
  • Measure the impact of the model across the organization
  • Align the model with the strategic priorities for the organization

Continuously investing in clinicians at every stage of their careers increases engagement, reduces turnover, and ultimately elevates performance. Recognize that sustainable improvement will come from an ongoing effort to refine and repeat this investment process along a clinician’s lifecycle.

Starting with the Recruiting and Hiring Process

Healthcare organizations and executives understand the importance of recruiting and retaining competent nurses. Especially as the increasingly competitive landscape of employment opportunities for the Registered Nurse plays a role in the available applicant pool. In fact, the employment opportunities for a nurse is expected to grow by 15% until 2026 (BLS,2018).

Recruiting nurses who can adapt and meet the increasing demands of providing safe and effective care for complex patient populations is an imperative.

Organizations can also begin to impact the quality of their hiring process through recruitment efforts. Placing a strategic focus on high-volume and hard to-fill positions can be a great start. With this focus in mind, organizations should consider high-performing work practices to identify their own strengths and core values as part of their recruitment process.

3 Ways To Improve the Quality of Recruiting

Human Resources, Talent Acquisition and Hiring Managers play a vital role in the quality improvement efforts of an organization through recruiting, identifying and filling open positions with the highest-quality candidates available from an applicant pool.

Use these three best practices to improve your recruiting and hiring process:

  1. Utilize an automated system focused on attracting top talent to an organization with a data-driven approach. In a pay-for-performance system, many organizations are prompted to streamline workflows, shift focus and resources on efficiency and processes that bring value. This could provide the ability to attract individuals with a common interest and desire to work for an organization whose strategic priority is quality and patient safety.
  2. Employ tools that are valid and reliable as a component to ensure consistency in the selection process. Tools used in the hiring process should be able to measure the specific knowledge, skills and abilities of the clinical role for which the applicant is applying. There are many components to consider in the hiring process. However, utilizing valid and reliable tools can provide tremendous insight into an applicant and assist Talent Acquisition and Hiring Managers to make well-informed decisions.
  3. Align key metrics with the organization’s strategic goals to assess the effectiveness of recruitment efforts. Tracking and measuring the effectiveness of recruitment efforts is essential to analyzing variations, trends and identifying opportunities for improvements as part of an overall continuous quality improvement process.

Continuing with an Onboarding Program

Healthcare organizations can also benefit in developing strategic partnerships among Human Resources, Nursing Leadership and Education, especially when it comes to ensuring readiness to practice for new nurses. Although these are separate entities with unique responsibilities, there is a cohesion when it comes nurse retention, nurse engagement and nurse satisfaction.

Here are three ways for the three departments to work together:

  1. Build an effective nurse orientation and onboarding program together, as an essential step to ensure a focus is placed on patient-centeredness, quality improvement and the application evidence-based practice (EBP). Recognize that Human Resources, Nursing Leadership and Education each has a specific role that they bring to the table in the effective onboarding of a new hire. Demonstrating an organizational commitment to a new hires success can further enhance the onboarding experience and sets the stage for their success. Studies have shown 69 percent of employees are more likely to stay with a company for three years if they had a positive onboarding experience.
  2. Use a personalized approach that addresses the unique needs of the adult learner in the onboarding process. Utilizing tools with the ability to deliver content addressing identified knowledge gaps can optimize learning for the new hire. One essential element for learning is to have the capacity to measure learning in a consistent manner with the ability to capture knowledge and clinical application in a meaningful way. Online tools that deliver content in a personalized way can certainly enhance nurse engagement and satisfaction. These tools can also lend value to the onboarding process by reducing time and resources. Organizations with large cohorts can benefit with a tool to support adult learning principles. This can further support the lifelong learning for the healthcare professional.
  3. Align key metrics with an organization’s strategic goals to assess the effectiveness of an onboarding program. Tracking and measuring the effectiveness of the onboarding process can assist in analyzing variations, trends, and identifying opportunities for improvements as part of an overall continuous quality improvement process. Metrics such as nurse engagement, nurse satisfaction, professional growth and improvements in knowledge as a few examples.

Final Thoughts

Clinicians are a healthcare organization’s biggest resource, directly impacting patient care and outcomes. Long-standing hiring and onboarding programs remain crucial, as well as innovative ways to adapt lifelong education to individual needs, which changes behavior and promotes continuous improvement.

In addition to hiring and onboarding, high-performing organizations also recognize the importance of professional development for new and incumbent nurses. The IOM’s Report, The Future of Nursing: Leading Change, Advancing Health, highlights the importance of lifelong learning and the impact this commitment can have on patient care outcomes.

By committing to the practice of three critical components, your organization will lead the charge to create an engaged, proficient, and motivated nursing workforce ready to take on the challenges of an ever-changing healthcare landscape.


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