How Nurse Assessments Can Reduce Onboarding Time

The Challenge

Retention data indicate that annual nurse turnover rates continue to escalate to over 16%. In addition, costs for a hospital to replace one RN is estimated between $55-85K. Several levers have been identified to help improve retention including a positive onboarding process. The question then becomes, how do we maximize onboarding to build a solid foundation for nurses?

The Study

Like many health systems challenged with attracting and retaining high-performing employees, a Relias Assessments client representing a regional west coast health system invested in strategies to reduce nurse turnover.

onboarding impact graph for relias assessmentsIn February 2016, three facilities integrated Relias Assessments into their nurse residency program to maximize the onboarding process. Nurse leaders chose Relias Assessments to both improve competency and reduce costs by individualizing each resident’s onboarding education and experience. The result was a time savings of 6 weeks and a cost reduction of $295K.

The goals of the nurse residency program:

  • Transition from student to nurse with ease and confidence
  • Identify and bridge the clinical gap for individual nurses
  • Enhance critical thinking and clinical decision making
  • Foster continuous professional growth and development
  • Demonstrate ROI through quality, retention and cost savings
  • Increase new graduate nurse retention rates while reducing overall RN turnover

Relias Assessments Program


The client administered Relias Assessments to new grad nurse residents to maximize the onboarding experience both for residents and for preceptors. Incumbent nurses were assessed to identify preceptors and then to match preceptors with residents based on behavioral alignments.

Residents completed the baseline assessments after general orientation to identify knowledge gaps, which helped build individualized learning plans. These streamlined plans included in-person and online content, plus meetings with managers and the preceptor.

In addition, preceptors were provided the Relias Assessments scorecard coaching report to guide preceptors on how to optimize working relationships with an individual nurse.

Then, Relias Assessments were re-administered to measure clinical knowledge growth and further define learning opportunities during the first year of practice.

Competency Improvement

As a result of using Relias Assessments data to customize learning plans, nurse residency onboarding time was reduced from 18 weeks to 12 weeks. In addition, 23 percent of nurse residents completed the program in less than 12 weeks. Furthermore, the shorter format contained the same amount of clinical bedside time as the previous program but with a reduction in classroom time.

Even with the reduced classroom time, Relias Assessments’ reporting tools demonstrated that 100 percent of Med/Surg nurses exceeded the modified Angoff score for the assessment at 8 weeks.

Cost Savings

In the first 4 months of the program at 3 of the system facilities, the client reported a cost savings of $295,000 by preparing nurses for independent practice sooner and reducing dual staffing costs. The system plans to expand this program to all hospitals by the end of 2017 and estimates savings to exceed $975,000.

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