3. Project Overview
Objective
• Recommendations for improving the onboarding process for new RCTs
• Creating a standardized process for bringing RCTs onto their assigned
Living Units after CIP training
Overview
• Onboarding is an important part of overall retention strategy
• Inconsistency in onboarding processes across living units leads to
variation in RCTs experiences
• Re-evaluating this process will help build a more structured approach
4. The Revolving Door
• “it’s like a revolving door—we are just making clones that come and go”
• High turnover rates and vacancies for RCTs
• Onboarding is one way to address new-hire turnover rates
• Answers question “how can we keep the revolving door from spinning out of
control?”
38%
16%
15%
11%
8%
5%
4%
3%
Percentage of Employees
RCT
LPN/Other Nursing
Medical
Other
Building/Maintenance
Office/Administrative
Food Services
RCS
Classification
5. Methodology
• Interviews
• UD’s, RCS’s, and Job Coaches to learn about current process
• Focus Groups –to gain opinions
• New RCTs and preceptors
• Survey
• For New RCTs
• Evaluated the impact of onboarding practices on comfort level
• Literature Review
• Research best practices from other leading organizations
6. #1
Supporting Evidence:
Key Result : Some living units currently apply some very positive
onboarding practices.
Best Practices Summary Table
Table 1.3. Best Practices at CWC Summary Table
Onboarding Activity Best Practice
Pre- Transition
Preparation
UD Introductions/ Unit descriptions in NEO
Exposed to living unit before transition in training
Introduction Meet UD on first day
Meet all team members
Tour Informal introductions during tour
Unit-Based Training exposed to each apartment/shift
RCT Role & Expectations
Talk in depth with nurse, psych, etc.
review job expectations
Socialization Use a welcome board
Preceptor Program RCS collaborates with preceptor
Evaluation/Monitoring UD check in with new RCTs on daily rounds
RCS, Job Coach, UD role RCS works side by side with RCTs
job coaches check in in the first few weeks
UD participates in the process
7. Survey Findings
Correlation Analysis
Best Practices correlate with
confidence/knowledge levels in
first week/first month
• Opportunity to meet Senior
leaders (.42)
• Job coach there to answer
questions (.58)
• Unit-Based Training(.64)
8. #1 Recommendation: Apply the best practices used by some units at
the center to other units.
Action Steps:
(1)Include best practices in the new employee toolkit as part of checklist
(2)Set reoccurring agenda item for a current meeting to share best
practices, knowledge, experiences
9. Key Result : There is no systematic, structured approach to
onboarding across living units.
#2
Supporting Evidence
Focus group theme: need increased consistency
Variation in terminology, perceptions of roles, and levels of involvement
Survey: Variation in information RCTs want more of
“It’s not consistent center -wide—we want consistency.”
45% 45%
15%
25%
20% 20%
5%
0%
10%
20%
30%
40%
50%
PercentageofRCTs
Topic
Please indicate the topic(s) you would have liked more information about.
10. Recommendation: Develop a comprehensive new employee toolkit
that includes checklists and a written onboarding timeline.
#2
Action Steps:
1. Create a new hire checklist for supervisors
2. Include
a. Logistics information
b. Specific onboarding timeline
c. Roles & Responsibilities
d. Key skills list
EX: Consistency, teamwork, communication, helpful
e. Advice
EX: “Don’t rush or get overwhelmed “Observe how other RCTs react",
"Carefully read DLP”, “Get to know people’s names fast”
3. Communicate to all members
4. Educate and train managers
5. Post resources electronically
11. Key Result : New RCTs experience an information overload during
the transition from CIP training to their assigned living unit.
#3
Supporting Evidence:
Focus Group theme: need more time
“There is lots of information, will probably take me the whole summer to learn”
“Already trying to retain a lot of information & DLP is not a small book”
“An extra week of working with another RCT would allow more time to absorb
information”
“We need more time to get to know residents better”
“Too much information”
12. #3 Recommendation: Modify the time period RCTs have to learn
unit-based information so it is longer and more participatory.
Action Steps:
(1) Create a realistic timeline
(2) Increase hands-on experiences
(3) Train employees on assigned unit
(4) Remind information over time
Pace delivery of onboarding information
“it’s a marathon not a sprint”
Assimilated
Employee
Onboarding
Length
Orientation
Facilities
Orientation
Paperwork
Company
Handbook
Company
Policies
Tour
Cultural
Mentor
On-the-job
Training
Feedback
Process
13. Key Result : There is no consistent approach to personal
welcoming from key people.
#4
Supporting Evidence:
Survey data shows “I was introduced to my co-workers” received 87%
Focus group theme:
variation in introductions
0% 20% 40% 60% 80% 100%
job coach was there
tour of living unit
my unit welcomed me
introduced to my co-workers
met with supervisor within week
opportunity to meet leaders
clear job duties and expectations
resources I needed
someone was assigned
assigned person welcoming
unit based training prepared me
skills check-offs were used
feedback on my performance
% of Respondants
OnboardingActivity
Please answer to following according to your experience: Yes or No
“They may act welcoming, but sometimes not that welcoming”
“there were no introductions”
14. #4 Recommendation: Speed the development of important working
relationships for new RCTs.
Action Steps:
(1) Managers welcome new employees their first day
(2) Provide framework for socialization in assimilation checklist
(3) Identify key people for new RCT to meet
(4) Include leadership profiles that include photos
(5) Prepare RCTs and others for productive conversations
a. clarify objectives of meetings
b. provide list of talking points
(6)Make formal and informal introductions
(7) Invite new RCTs to key meetings
(8) Conduct consistent check-ins with relationships
Preparation
-prepare checklist
-set up meetings
- brief bios, background
Delivery
- formal/informal
introductions
Follow-Through
-check in consistently
15. Key Result: There is an opportunity to improve the understanding of the
preceptor role and responsibilities for both the new RCT and the RCT preceptor.
#5
Supporting Evidence
Survey indicates RCTs want to learn more information about roles/expectations
45% 45%
15%
25%
20% 20%
5%
0%
10%
20%
30%
40%
50%
PercentageofRespondants
Topic
Please indicate the topic(s) you would have liked more information about.
16. • Focus group comments
o “It was kind of scary; I was new and training right away and it was different”
o “RCTs look at it like an ‘easy day’ or ‘rest day’”
• Survey: preceptor contributes most to onboarding experience
52%
13%
48%
30%
4%
0%
10%
20%
30%
40%
50%
60%
Preceptor Introductions Unit-Based
Training
Feedback Other
PercentageofResponses
Onboarding Activity
Which activity contributed the most to your experience starting to work on the unit?
17. Recommendation: Create a more structured preceptor program.
#5
Action Steps:
(1) Recruit voluntary preceptors
(2) Educate preceptors about role and responsibilities
(3) Have consistent preceptors
(4) Develop and communicate clear expectations
(5) Preceptors collaborate with the RCS
(6) Preceptor and new RCT should remain together
(7) Increase recognition
(8) Monitor Preceptor Performance
18. Key Result: There is no consistent process owner(s) for the
onboarding program that integrates the activities of stakeholders or
holds them accountable.
#6
Supporting Evidence:
No consistent ownership of specific activities
“most of the time this person does it” or “when I am here this is what
happens-but I don’t know about when I’m not here”
Interview “there is no point person for the whole process—who is going to
help them when they get onto the unit?”
Variation in levels of responsibility associated with roles
EX: job coaches providing reminders to a “variety of roles including
coach, parent and others”
19. Recommendation: Increase accountability for the onboarding
process by establishing an owner of the whole process and defining
who controls various steps.
#6
Action Steps:
(1) Identify a process leader
(2) document key roles, responsibilities
(3) Increase leadership involvement
Survey: largest correlation for confidence in
first week is “the opportunity to meet senior leaders”
20. Key Result: There is an opportunity for better preparing new RCTs
for working with individuals at CWC.
#7
Supporting Evidence:
Survey responses:
• Unit-Based training on all apartments
• Train in assigned living unit
• Increase interaction with residents in assigned building
Focus group themes
Transition is overwhelming
“Hectic, shocked, never knew a G-tube existed”
“Stressful and felt rushed, behind and frustrated”
“There was a lot of frustration, just kind of
thrown out there”
Training isn’t realistic
“Once on the units it was different than the way to pass
certification”
“Should train on each apartment evenly so you get
comfortable going to all apartments”
“If you work the way they teach you, you won’t get anything
done—especially bathing”
21. #7
Action Steps:
(1) Have workforce SMT develop a multidisciplinary team
including leadership, Unit Directors, and other relevant employees
(2) Identify content areas to include in Unit-Based Training
• Active Treatment
• Remind of NEO content
• Emphasize CWC guidelines and policies
how to get acclimated and how its different than CIP training
(3) Evaluate variables such as:
• time requirements of new RCTs
• how consistent training can be made across units
(4) Develop an improvement plan to modify Unit-Based Training
Recommendation: Expand Unit-Based training to better
prepare new RCTs for working with individuals at CWC.
22. Key Result : There is not a performance evaluation system for the
onboarding process.
#8
NEO evaluations but no follow-up after NEO
No measures of the long-term impact of onboarding activities
Recommendation: : Seek further feedback on onboarding
program from new employees
Action Steps:
(1)Identify Process measures (were they introduced, was a checklist used)
(2) Identify Results/outcome measures (reduced turnover, increased
retention/confidence)
(3)Monitor onboarding program effectiveness over time
23. Key Takeaways & Guiding Principles
Importance of applying best practices
Increase accountability
Increase consistency
Support implementation
Everything Matters:
bring greater attention to each and every aspect of onboarding process
Little things make a big difference
Checklist, introducing yourself
