February 2, 2021

Transforming Healthcare Onboarding from Process to Adaptive Experience

According to an onboarding survey by Ivanti, 85% of new employees lack the resources they need to perform on the first day of their assignments. When you consider the rigors of healthcare positions, and the tremendous demands created by the COVID-19 pandemic, effective onboarding in this field becomes a pressing concern. That’s why an adaptive onboarding experience—which unites protocol, preparation, and perspective—is essential to healthcare staffing.

Why Is Onboarding Essential Now? Renewed Focus on Candidates

As with so many aspects of the wfemporkforce solutions industry, the pandemic has shifted our emphasis on countless strategies, Onboarding has long been seen as an important area for improvement, but with the resurgence of new talent shortages, retention issues, hyper-competitive hiring issues, and engaging talent who demonstrate a greater reluctance to change, onboarding has emerged as a key consideration.

In fact, during the ProcureCon Virtual Expo in January, several meetings involved discussions on enhancing the onboarding process as the foundation to driving contingent labor advocacy and sourcing strategies. The topic was most profound for the industries that have soared to new heights in response to the “new normal” of COVID-19: industrial and logistics, IT, and healthcare. 

The trend will only increase, especially since President Joe Biden recently signed the Executive Order on a Sustainable Public Health Supply Chain. In it, the president specifically invoked taking “appropriate action using all available legal authorities, including the Defense Production Act, to fill those shortfalls as soon as practicable by acquiring additional stockpiles, improving distribution systems, building market capacity, or expanding the industrial base.”

The Defense Production Act is the primary source of presidential authorities to expedite and expand the supply of materials and services from the U.S. industrial base needed to promote the national defense

Onboarding is no longer a basic orientation session to familiarize new employees with a company’s policies and procedures. It has evolved into a full-fledged “experience”—an acculturation event where talent are encouraged to embrace the organization’s mission, values, diversity, and environmental mindset. Fostering team cohesion and brand advocacy can absolutely inspire dramatic gains in morale. But along the way, have we lost sight of the logistics and imperative process components of this “experience?” 

Effective Onboard Is Imperative in Healthcare Staffing

RiAnn Bradshaw from BlueSky, a recruiting software platform dedicated to healthcare, summed up the situation in a recent article about personnel shortages in the medical and healthcare spaces.

Today's healthcare talent shortages allow doctors, nurses, hospital administrators, and other medical professionals to be selective about where they work – and for how long. For HR managers, healthcare recruiters, hospital administrators, and related medical organizations, it’s never been more important to take a closer look at the best strategies for talent development and retention practices.

Smartsheet’s Becky Simon posted an incredibly comprehensive piece last March about the urgent need to concentrate on compliance and best practices in healthcare onboarding.

Healthcare is one of the most regulated industries in the United States, and despite stringent laws that have been in place for decades, many healthcare providers have much work ahead of them before they attain compliance. Meeting regulatory standards is vital to patient health and safety, as well as to protect the organization from fines and litigation.

Riley Woodward, Customer Success Manager at Smartsheet, also noted that “operating without targeted onboarding compliance strategy and tactics exposes healthcare organizations to significant legal and financial risks.” In 2018, violations by multiple insurance or health provider organizations resulted in multi-million-dollar fines — in fact, Anthem, Inc. paid a record-breaking $16 million for violating patient privacy rules.

Of course, there remains the challenging hurdle of talent shortages. 

  • Turnover and attrition of hospital personnel has averaged 85.2% since 2013.
  • The national average for the RN turnover rate is 16.8%, a 2.2% increase from 2016.
  • The United States will be short 1.2 million nurses by 2022.
  • And the shortage of U.S. primary care physicians will range from 14,800 to 49,300 by 2030.

“Despite the benefits, most healthcare organizations aren’t quite where they need to be with onboarding, particularly in making use of online solutions,” said Woodward. “That’s what we help to do: Forge an individual’s connection to the organization. When people can quickly and easily access information and assistance, it can make all the difference between job satisfaction and an early departure.”

Onboarding Benefits

Onboarding, when conducted properly, represents an integral and continuous momentum throughout the employee lifecycle that cultivates engagement, retention, and satisfaction. Here are some other crucial aspects.

  • Successful onboarding helps instill a sense of commitment to ongoing improvement.
  • Employees who participated in a compelling onboarding experience demonstrated greater performance levels.
  • Solid acculturation techniques bolstered employee loyalty.
  • Stronger retention leads to lower turnover, which contributes to healthier operating costs and profits. According to the 2016 National Healthcare Retention and RN Staffing Report, an average hospital can lose $5.2 to $8.1 million annually due to nurse turnover. 
  • Nearly 65% of people admitted to leaving their positions following a negative onboarding experience, according to a survey conducted by the tech company bob, a Human Resource Information Systems (HRIS) provider.

Adaptive Onboarding

Adaptive onboarding processes are modern iterations of the standard orientation and acculturation methods. Unlike the highly structured and group-based approaches we typically use, adaptive processes are designed for flexibility, personalization, and speed. Adaptive onboarding begins by discovering the needs of both the business and the workers, relative to their mutual success. It relies on a personalized approach to support new talent. Despite the attention spent on personalization, an effective strategy also requires technology.

  • Data: Collect and analyze data from every onboarding to determine the alignment between your processes and the need of your talent.
  • Gap Analysis: The big focus on culture is obviously important, but we can’t forget the essentials. Identifying gaps in skills upfront will prevent dissatisfaction, turnover, and re-training. Standardized onboarding prioritizes qualifications and certifications; adaptive onboarding seeks to understand whether the candidate’s strengths will complement and strengthen the business’ needs.
  • Training: Use tech platforms to create customized training sessions through video lessons, live chats, access to enterprise learning platforms, and more. For healthcare talent, more in-depth training is required to ensure that they grasp every nuance of the strict regulations that will affect them, including the Health Insurance Portability and Accountability Act (HIPAA), protected health information (PHI) and medical records, and the Occupational Safety and Health Act (OHSA).
  • Virtual walkthroughs: Use video streaming or conferencing systems to conduct virtual walkthroughs of facilities, where employees and managers can introduce themselves and connect with the new candidates prior to onsite visits, which are much riskier in the era of pandemic.
  • Documentation: Make sure that all required forms and documents (e,g, I9s, W4s, direct deposit, benefits enrollment, screening authorizations, etc.) are accessible through a secure online platform with electronic signature capabilities.
  • Mentorship: Consider working with the client to assign a dedicated mentor to candidates or candidate groups. Internal staff can ease the transition and serve as  a resource for information. Especially in healthcare, having a senior nurse in that department can ease transitional obstacles.
  • Ongoing Communications: You are still the legal employer of the workers you place. Be present, remain consistent in your outreach to your workers, provide routine updates and knowledge bases, connect with them for the heck of it, and make sure that your HR and management teams are available to address issues as they arise.

Proactive Preparation

To be truly inclusive—and establish a robust, meaningful program that prepares new talent to hit the ground running—onboarding must provide the tools employees require. A carefully orchestrated onboarding experience can still fail when it’s too much experience and not enough process.

It’s Not the Destination, It’s the Journey

Imparting corporate goals and assignment objectives is a critical component of onboarding. But the goal alone doesn’t tell workers everything they should know. MSPs and staffing suppliers must collaborate with clients to obtain the details that prepare talent for the path toward achieving those ends.

  • Share the company’s actual roadmap and strategy to provide direction, context, an understanding of team roles, and priorities.
  • Define the client’s internal communication styles: expectations, processes, systems used, synchronous versus asynchronous approaches, and cross-collaboration.
  • Prior to onboarding, work with the client’s IT to set up user accounts in the communications platforms that will be used and incorporate training into the onboarding.

Prepare in Advance

In an outsourced contingent workforce management program, a client’s hiring managers are going to leave the onboarding to the MSP. Staffing partners can assist. 

  • Ensure that the onboarding process is consistently executed
  • Monitor compliance with pre-employment processes (drug screens, background checks, confidentiality form executions)
  • Provide guides, forms, handbooks, and other required orientation materials, customized to the needs of each healthcare position you staff
  • Coordinate periodic audits of compliance with drug testing, background screening, and confidentiality form execution
  • Ensure that onboarding documents, screening requirements, NDAs, licenses and certifications, and other vital documents are stored and tracked in secure, accessible systems

MSPs and staffing suppliers, if possible, should coordinate with the client’s IT to provision technology assets and providing access to networks, Internet, file servers, computers, and more. If the resources for new workers are set up prior to the onboarding date, training and day one activities can be expedited. 

  • Issuing and setting up equipment (e.g., computers, telephones) for new talent
  • Setting up corporate accounts and networks
  • Granting access to appropriate platforms (e.g., shared drives or other internal systems)
  • Developing or deploying software or other technology solutions that support onboarding
  • Training procedures for use of any related assets

The client’s Facilities staff can also take proactive steps to accelerate output by arranging for office space to accommodate new talent. MSPs and staffing suppliers should coordinate with these resources to assist with:

  • Identifying and arranging desks and work spaces
  • Preparing office supplies that will be needed


To prevent issues or miscommunication, establish roles, chains of command, and accountability with HR prior to deploying an onboarding program. Work with HR (or the identified onboarding owner) upfront to identify key resources, determine performance standards, and document shared onboarding goals that will be reported back at the conclusion of onboarding. Always solicit feedback from the client, MSP, and talent to drive continuous improvement.

Healthy Onboarding for Healthcare Talent

Adaptive onboarding programs cover the basics while tailoring elements of the program to specific types of talent. In developing the onboarding program, consider the needs of new workers and their expectations of the onboarding experience, in addition to the requirements, resources, and tools for mandatory activities. As we outlined in our latest ebook “New Talent Strategies for our New Normal: A playbook for contingent workforce innovation in the pandemic era,” new models will evolve that can break ground on solving the issues our businesses and our talent will face in the post-pandemic era. Healthcare professionals, more than others, will need our help to overcome the challenges that await in order to reap the successes to follow. Attracting, engaging, and retaining these vital individuals has always been vital, but today it’s mission-critical.

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