Creating an Exceptional Onboarding Experience for Your New Employees

Retention is one of the most pressing issues on the minds of C-suite leaders in all industries today, not just in the United States, but around the world. Yet many healthcare organizations are dropping the ball when it comes to onboarding, one of the most effective retention tools at their disposal. As Carucci(1) warns, “Companies often spend very little time onboarding new hires.” Dewar(2) agrees, reporting that a whopping 88% of organizations “don’t onboard well” and that only 1 in 10 of employees believe that their organizations did a great job of onboarding them.

The first days and months with a new hire are critical in the life cycle of that employee.

Healthcare organizations that craft exceptional onboarding experiences are much more likely to retain new hires than those that don’t. Exceptional onboarding also results in higher new employee productivity. There are numerous metrics to support these arguments. For example, Apollo Technical(3) reports, “69% of employees who have had a great onboarding experience are likely to stay for at least three years.” SHRM(4) reports that organizations that use a standard onboarding process can expect 50% greater new hire productivity than those that don’t. And Apollo Technical reports that 1 in 10 employees who leave an organization do so because of a poor onboarding experience, and that 37% of employees report that their manager did not play a critical role in their onboarding experience. That’s a significant gaffe in the onboarding experience, Apollo Technical says.

The first days and months with a new hire are critical in the life cycle of that employee. Carucci describes the entire first year of employment as employees’ most vulnerable period and reports that up to 20% of staff turnover occurs in the first 45 days of employment. Starting new employees on the right foot can stack the deck in your favor for better retention and productivity, because, as Hirsch(5) suggests, onboarding fosters better employee engagement and job satisfaction. For this reason, Hirsch urges, “Onboarding is a prime opportunity for employers to win the hearts and minds of new employees. Don’t waste it.”

What is Onboarding?

Onboarding refers to the processes through which new hires are integrated into the organization. It includes activities that allow new employees to complete an initial new-hire orientation process, as well as to learn about the organization and its structure, culture, vision, mission, history, and values. For some organizations, the onboarding process consists of one or two days of activities; for others, onboarding may involve a series of activities spanning one or many months, or even a full year. During onboarding, the organization provides new employees with training, knowledge, and resources that will help them to succeed in their new positions, but as you’ll see, onboarding usually has a social component, too.

Onboarding is often confused with orientation, but there is a difference. SHRM(4) explains, “While orientation is necessary for completing paperwork and other routine tasks, onboarding is a comprehensive process involving management and other employees and can last up to 12 months.” Orientation is usually a one-time event welcoming new employees to your organization. Onboarding is a series of events (including orientation) that helps new hires to understand how to be successful in their jobs and the culture of the organization, and how their work contributes to the greater good. Generally, the longer the onboarding process, the better. As Apollo Technical explains, “Longer onboarding programs are associated with stronger talent and business outcomes such as employee engagement, business reputation, quality hires, and the percentage of diverse hires.”

All new employees are onboarded, even if that means that they are left to their own devices to observe what’s going on and to figure things out on their own. However, a high-quality, structured onboarding experience designed by the organization will yield the best results. SHRM warns, “Too often, onboarding consists of handing a new employee a pile of forms and having a supervisor or HR professional walk the employee around the premises, making introductions on an ad hoc basis.” That is not a quality onboarding program, SHRM says.

Onboarding that is formalized and thoughtfully structured lays a foundation for long-term success for both the employee and the employer. Exceptional onboarding can improve productivity, build loyalty and engagement, and help employees to succeed early in their careers with the new organization. It can positively influence the way they think about their jobs more broadly. As Dewar says, “70% of team members who had exceptional onboarding experiences say they have ‘the best possible job.’” Conversely, Hirsch warns, new hires who experience badly planned and executed onboarding may conclude that the organization is “poorly managed” and may wonder if it was a mistake to take the job. Such doubts do not bode well for employee satisfaction, confidence, loyalty, productivity, or retention, Hirsch says.

Who Does Onboarding?

Typically, the responsibility for onboarding falls to HR. Graham(6) says that depending on the size of the organization, “HR could be one person, a team of people, or a department across multiple locations.” In larger organizations, HR personnel who lead or take part in onboarding may have specialized recruiting and learning roles. As well, several non-HR employees will share responsibility for onboarding by introducing new hires to different aspects of the organization. Even so, there is usually one person in HR who oversees the new hire’s onboarding, schedules onboarding activities, troubleshoots, and serves as the point person for the new hire and others throughout the onboarding process.

The new hire’s direct supervisor should play an active role in the onboarding process. Graham explains, “Given that most people stay at (or leave) a job due to their relationship with their immediate boss, organizations should pay close attention to the roles of managers and supervisors during onboarding.” It’s important that managers establish one-on-one relationships with their direct reports as soon as possible. For some organizations, this occurs on the new hire’s first day. For others, it happens when new employees are handed off to their managers after completing basic orientation activities. Graham says, “One primary responsibility for managers and supervisors is to illustrate the link between a new employee’s job and the organization’s larger mission.” In addition, managers are best equipped to set expectations and to teach new employees about what their jobs entail. Onboarding is also the best time for managers to discuss job and performance expectations. Graham suggests, “The faster employees understand the components of the job and expected performance levels, the shorter their time to productivity.”

The healthcare organization’s leaders, too, should be involved in onboarding new hires. HR Cloud(7) suggests, “Leaders can be called upon to share stories and the narrative of the organization.” They are in the perfect position to describe the organization’s history and culture and its overall business strategy, mission, vision, and values. The presence of leadership in onboarding reinforces the importance of the content to new employees. More importantly, it demonstrates that the leaders have a firm grasp on where the organization has been and where it is going and that they are accessible, not locked away in a C-suite and never seen. As Bradt(8) suggests, “You get the employee engagement you deserve. If leaders don’t engage with their workers, the workers won’t engage with the organization.”

Peer mentors also can be part of the onboarding process. Apollo Technical suggests that a peer mentor eases the learning process by serving as the new hire’s go-to person for questions, a sounding board for their concerns, and a supportive peer who can guide them in their early days with the organization. Ideally, peer mentors will be employees who exemplify the characteristics that would be desired in the new hire, Apollo Technical says. Therefore, choose your peer mentors carefully. Negative peers can do more harm than good by sharing gossip, unsavory stories, and negative opinions. Don’t allow negative influencers to serve as peer mentors, or they will poison your new hires before they have had an opportunity to form their own opinions.

An inspiring presentation by one of your leaders can be an effective kickoff.

Finally, some organizations include other stakeholders in the onboarding process. A member of a governing board, for instance, can play a role in onboarding, depending on the new hire’s responsibilities. So, too, can a representative of a contracting firm with whom the new hire will interface. Likewise, one or more patients can help with onboarding by providing new hires with their own perspectives about the organization.

Begin with Pre-Boarding

Onboarding does not have to begin on the employee’s first day on the job. It can and should begin the moment your job candidate accepts your offer, because early onboarding is extremely effective. According to Aberdeen Strategy Research,(9) “Companies that use pre-boarding retain 81% of first-year hires.” Furthermore, organizations that pre-board new hires are 11% more likely to retain their first-year employees than those that don’t. The goal of early onboarding, or pre-boarding, is to get new hires excited while affirming that they’ve made the right choice to take a chance on a new job. If pre-boarding is done well, it will link new employees to the organization in a positive way before they report for their first day of work. Greaves(10) suggests, “The focus [of pre-boarding] should be preparing your new hires and drumming up some excitement as their first day approaches.”

The weeks between offer acceptance and the start date present a crucial engagement opportunity. Bell(11) suggests that organizations make the most of that time, adding, “Trust us, your new hires will appreciate it.” Here are several examples of effective pre-boarding activities:

• Facility tour: Invite new hires (and, perhaps, their families) to tour your healthcare facility. (SHRM suggests that this visit may include a house-hunting trip and community tour if a new hire will be relocating for the job.)

• Helpful documents and literature: Mail or email helpful information about the organization to new hires, including benefits options, your organizational chart, and literature for employees and patients.

• Gifts: Send a gift to new hires, such as cookies, coffee, a coffee mug with the organization’s logo, or other logo wear.

• Peer mentor: Match the new hire with a peer mentor or buddy who connects before the new hire’s first day to offer a sincere welcome and answer basic questions.

• Communication: Send new hires their new email address and phone number, along with access details for using your communication tools.

• First-week schedule: Provide new hires with an itinerary for their first week (at least). Greaves says, “This simple gesture is a fabulous way to help them combat their first-day nerves!”

• Paperwork: Ask new hires to complete routine paperwork prior to their first day. Greaves suggests: “It’s clear that no one wants to spend their first day wading through paperwork. So encourage new hires to complete and submit documents like their W-4 and I-9 forms before their first day.”

• Feedback: Ask new hires for their feedback about the hiring process. Greaves suggests that doing so can go a long way in strengthening their impression of what kind of organization you are. Yet, according to Dewar’s research, only 26% of new employees recall being asked for feedback on their candidate journey and the hiring process before their start date. “But when employers ask for feedback,” Dewar says, “new hires are 91% more willing to increase their relationship out of the gate. This is crucial for reducing 90-day turnover and bolstering long-term retention.” New team members who were asked to provide feedback prior to their start date also had a 79% increase in willingness to refer others to the organization, Dewar reports.

• First-day instructions: Provide detailed instructions for the new hire’s first day. Greaves says that about 50% of new hires worry that they will be late to their first day at work or show up to the wrong place. Help nip that anxiety in the bud by making sure they know where they will need to be—the address, the department, and the person they need to report to. Provide instructions if the office is tricky to locate, or if it typically takes more than a few minutes to walk from the parking lot to the office. Provide information about your dress code, parking, and check-in, as well as any materials new hires should review before their first day.

Additionally, look for opportunities to engage your current employees in the pre-boarding experience. For example, the new hire’s team can send him a welcome email with quotes about why they love working in the organization or why they are excited to work with him. Or, as Bell suggests, the team can make and send a welcome video. That may be even better than an email because new hires can begin to put names and faces together before meeting everyone in person. Bell also suggests that you share the new hire’s LinkedIn profile with her new colleagues and prompt them to connect with her. Greaves suggests that you also ask the new hire’s manager to congratulate her on making the cut and to welcome her to the team. Be mindful, however, that although these are all great ideas, you don’t want to bombard new hires with too many pre-boarding emails, packages, gifts, or calls. Choose a few and schedule them optimally. As Greaves suggests, “Opt for strategic communication about things that will matter in their employee journey,” but don’t overwhelm them.

First-Day Onboarding Activities

Most new hires arrive to their first day filled with high hopes and excitement. Yet, Aberdeen Strategy Research reports, 50% of organizations say that their onboarding program is focused on routine processes and paperwork. The best and most effective employee onboarding programs focus on “people, not paperwork,” Aberdeen Strategy Research says. Therefore, carefully plan first-day onboarding activities so that the very first things new hires experience at work are engaging and uplifting, not a pile of boring paperwork and lists of do’s and don’ts. Keep the day upbeat and interesting to avoid what Hirsch describes as “death by orientation.” Reinforce your new hires’ enthusiasm by demonstrating that they made a wise decision in choosing to work for your healthcare organization.

If possible, “bookend” the new hire’s first day by having her meet with her new manager before and after group onboarding activities. These would be two 30-minute meetings with her manager, the first one first thing in the morning for a welcome, the second at the end of the day for a debrief. Bookending provides a chance for a warm and personalized one-on-one welcome, begins the new hire’s relationship with her manager well, and demonstrates the manager’s role as a resource, guide, and helper.

After the morning meeting with the manager, welcome new hires as a group and tell them what to expect of the day. Then, focus at least the morning of Day 1 on your healthcare organization’s culture and on forming connections. This is the perfect time to tell stories about your organization’s history, values, and big-picture vision for the future. An inspiring presentation by one of your leaders can be an effective kickoff. Then, spend some time focusing on the new hires by facilitating an engaging icebreaker activity that connects them to your organization. For example, if service to others or trust or respect are some of your organization’s core values, encourage new hires to share how those values are important in their personal lives. Break larger onboarding groups into smaller groups of four to six so everyone will have a chance to speak and connect.

Plan a lunch for Day 1 new hires if you can so they have a chance to socialize and form bonds with one another. Invite a few peer mentors and other stakeholders to the lunch, if possible, to interact with your new hires and to get to know them in an informal way. Dedicate the lunch to “informal small talk,” Greaves says, not to work details. To help, give each table a list of interesting conversation questions to stimulate their discussion.

Dewar reports that career development is a leading reason that employees leave their jobs, and that addressing development during onboarding increases new hires’ onboarding satisfaction by a factor of 3.5. Therefore, dedicate some time after lunch to the topic of career development. Dewar urges, “Let your new team members know how important learning and development are at your organization.” Describe opportunities for training, career advancement programs, credentialing, mentorship programs, and tuition reimbursement. If possible, ask one of your most successful current employees to describe her career path and how she took advantage of your various development opportunities.

You may take care of some necessary processes and paperwork after you’ve discussed career advancement. However, don’t end the day with that. Instead, end the first day of onboarding on a high note with another engaging and uplifting activity. Do your best to send your new hires home pumped up about their new jobs and your organization. Then send them back to their managers for their bookended 30-minute debrief.

The Remaining Onboarding Experience

Human beings, by nature, like to look ahead. Greaves says, “We like to plan for, anticipate, and straight-up daydream about what’s coming and what might be.” You will be well on your way to high retention if you can get your new employees excited about their future in your healthcare organization. Therefore, after the first day or days of onboarding, provide your employees with a schedule of their remaining onboarding experience. Show them everything they are going to do in the weeks and months ahead, and when. That will give them a roadmap to their learning and put to rest any concerns they may have about having to figure everything out on their own.

Dewar reports that the total average new hire onboarding experience consists of 54 discrete activities, both large and small. The average new hire will be assigned three documents to sign, upload, or acknowledge and 41 administrative tasks to complete, Dewar says. They will also have 10 learning outcomes to strive for—the learning goals they must achieve within topics such as organizational culture, market knowledge, and role alignment. They also will encounter various instruments to assess their learning. Exceptional onboarding programs vary the learning tasks so that they appeal to various learning styles. For example, an onboarding program may ask new hires to read articles or books, watch videos, listen to podcasts, explore websites, observe or shadow someone, engage in live or virtual conversations, attend live or online classes, journal, role play, interview someone, or solve hypothetical problems, among other learning tasks. Dewar says, “This variety of activities ensures the new hire is fully acclimated and integrated into their new role.”

Make sure that your new hires know that completing your onboarding program is mandatory and that positive performance reviews will depend upon them doing so. An onboarding overseer, typically someone in HR, must facilitate the remainder of the new hire’s onboarding. He or she must monitor and assess the new hire’s progress toward learning outcomes and bring the new hire back on track if his onboarding efforts decline. Managers also will want to stay in frequent contact with their new hires throughout the onboarding process. Dewar suggests that they check in at specific times, such as on days 1, 7, 14, 30, 60, and 90, at a minimum. According to Dewar, “When the manager takes an active role in onboarding, team members are 3.4 times as likely to feel like their onboarding process was successful.”

Design your onboarding program so that it ends with a bang, not a whimper. For example, design an onboarding capstone project in which the new hire writes a paper or delivers a presentation to peers about what he’s learned through onboarding. Then, share feedback one-one-one with each graduate of your onboarding program. Also ask your graduates to provide you with feedback so you can identify ways to improve your onboarding program. Congratulate them with a certificate or a small gift. Then, encourage and guide your graduates to continue their learning by developing individualized learning plans with their managers that include new learning goals, activities, and assessment instruments. Point them to programs and tools both inside and outside your healthcare organization that can help them to continue to learn as they move forward in their careers.

Reboarding

Reboarding is a process of reintroducing existing employees to the workplace after an extended absence. It refers to a formalized program for employees who are returning from a furlough, medical leave, or temporary assignment; returning to the physical workplace after working virtually: or in some cases, experiencing an internal transfer or promotion. According to Beltran,(12) “The goal of reboarding is to reassimilate employees into their positions successfully.” Therefore, reboarding should update the employee on current and new projects, help him acclimate to new team cultures and relationships, and share with him different expectations, policies, and other changes that have occurred in his absence. SHRM says, “Investing in reboarding can lead to increased productivity in a shorter time frame and allow employees the time to reconnect socially and emotionally to their teams and work, resulting in stronger engagement and job satisfaction.”

Reboarding employees already have significant knowledge of the organization’s culture, benefits, and administrative processes. Their reboarding generally takes less time than the employee’s initial onboarding. In most instances, the employee’s manager will integrate the employee into his role and the new culture of the team, while an HR professional will help the employee to complete necessary paperwork and/or administrative tasks and learn about changes in the organization’s structure, benefits, development opportunities, governance, and policies. Of course, reboarding provides needed information to the employee, but more importantly, it offers the opportunity for the employee to feel confident, motived, and refocused. It addresses individual well-being, positivity, and productivity as employees become accustomed to the changes that have occurred in their absence or that go hand-in-hand with their transfer or promotion. Most importantly, reboarding should have a social component. Beltran explains, “A reboarding process should restore camaraderie, communication, and community, as well as strengthen ties to the business and among team members.”

It can be scary to return to work after a long absence or to take on new responsibilities. There may be new team members the employee won’t know, new ways of doing things, and shifts in staff or policy. Even veteran employees may feel anxious at such a tender moment in their careers. A structured reboarding program can be a great comfort and allay concerns or fears about returning to work or stepping into a new role.

References

1. Carucci R. To retain new hires, spend more time onboarding them. Harvard Business Review. December 3, 2018. https://hbr.org/2018/12/to-retain-new-hires-spend-more-time-onboarding-them . Accessed January 17, 2022.

2. Dewar J. 10 employee onboarding statistics you must know in 2022. Sapling. January 3, 2022. www.saplinghr.com/10-employee-onboarding-statistics-you-must-know-in-2022 . Accessed January 20, 2022.

3. Apollo Technical. Why onboarding is important and a key to success. Apollo Technical. July 26, 2021. www.apollotechnical.com/why-onboarding-is-important/ . Accessed January 17, 2022.

4. Understanding employee onboarding. SHRM. www.shrm.org/resourcesandtools/tools-and-samples/toolkits/pages/understanding-employee-onboarding.aspx . Accessed January 20, 2022.

5. Hirsch AS. Don’t underestimate the importance of good onboarding. SHRM. August 10, 2017. www.shrm.org/resourcesandtools/hr-topics/talent-acquisition/pages/dont-underestimate-the-importance-of-effective-onboarding.aspx . Accessed January 17, 2022.

6. Graham T. Employee onboarding as a shared responsibility. KPA Blog. June 16, 2020. www.kpa.io/blog/employee-onboarding-as-a-shared-responsibility. Accessed January 25, 2022.

7. The onboarding process: who is responsible for what? HR Cloud. May 19, 2014. www.hrcloud.com/blog/onboarding-whose-job-is-it-anyway/ . Accessed January 25, 2022.

8. Bradt G. Leaders must take onboarding personally. Association for Talent Development. May 13, 2014. www.td.org/insights/leaders-must-take-onboarding-personally . Accessed January 25, 2022.

9. Aberdeen Strategy Research. Perfecting the onboarding funnel. Aberdeen Strategy Research. September 22, 2016. www.aberdeen.com/hcm-essentials/perfecting-onboarding-funnel/ . Accessed January 26, 2021.

10. Greaves R. 7 best practices for a killer pre-boarding experience. Harver.com . December 11, 2019. https://harver.com/blog/pre-boarding/ . Accessed January 25, 2022.

11. Bell A. 7-steps to perfect employee onboarding process for new hires & best onboarding software platforms in 2022. Snacknation.com . https://snacknation.com/blog/onboarding-process/ . Accessed January 25, 2022.

12. Beltran E. A guide to reboarding employees during and after the pandemic. Forbes. October 29, 2021. www.forbes.com/sites/forbesbusinesscouncil/2021/10/29/a-guide-to-reboarding-employees-during-and-after-the-pandemic/?sh=5d6a40e71033 . Accessed January 29, 2022.

The Three Dimensions of Onboarding

A well-designed, structured onboarding program is not an event, but an experience that is strategic and scalable. Specifically, Carucci(1) suggests that great onboarding addresses three dimensions of the employee’s experience:

1. Organizational onboarding: Exceptional organizational onboarding programs address how basic things work in your organization, yet they don’t overwhelm new hires by throwing too much at them at once. They generally begin with an orientation that focuses on what new hires need to know to succeed in the first few weeks on the job. As Carucci explains, “These include where to get an ID card, how to navigate the building, and how to enroll in health benefits and educate themselves on regulations and policies.” Organizational basics also include clocking in and out, where to stow personal items and lunches, where to find coffee and bathrooms, and where to take a break. Organizational onboarding also provides a crash course in your workplace lingo. Carucci says, “There’s almost always a litany of cryptic acronyms that companies use for key processes or roles — decoding them can be one of the most distressing challenges for new hires.” The more a new hire must awkwardly ask, “Sorry, I’m new. What does SSRP stand for?” the more they feel like an outsider. Simple tools like glossaries of terms and acronyms can help new hires to get up to speed quickly, Carucci suggests. Organizational onboarding also includes activities that intentionally help new employees to assimilate and adapt to organizational values and norms. Therefore, Carucci suggests, “At key intervals—three, six, and nine months—hiring managers should formally engage them [new hires] in conversations about the organization’s history and brand, how performance is measured and rewarded, and how growth opportunities arise.”

2. Technical onboarding: New hires may have been hired for their capabilities and experience, yet not know how to deploy them in your healthcare organization. Even those with deep areas of expertise may become insecure and anxious when they suddenly feel like beginners. They will often cite past successes to prove their competence. This can quickly exhaust their new colleagues, who will tire of hearing the new hire start each sentence with, “In my last job.” Technical onboarding will boost new hires’ confidence. To start, provide new hires with job descriptions that include well-defined accountabilities and boundaries. Help them to understand where their autonomy begins and ends. Provide opportunities for early wins. Carucci reports, “An astounding 60% of companies report that they do not set short-term goals for new hires.” Yet, they should, Carucci says, to boost their confidence. Schedule weekly coaching sessions. Assign tasks with an expectation that they be completed at the three-, six-, and nine-month marks, starting with targets you are confident your new hires can meet. Then gradually increase the level of responsibility associated with each task. Discuss gaps in new hires’ skill sets and work to close them; discourage new hires from faking it. Most importantly, help new hires to understand why their contributions matter. Carucci says, “New hires that feel grounded in their contribution and understand how it fits into the larger organization gain confidence and feel loyal faster.”

3. Social onboarding: Carucci reports that 40% of adults report feeling lonely. This sense of isolation is amplified for new hires, who often feel like a stranger in a foreign land. Unfortunately, their loneliness can increase the chances of them leaving the job. That is why social onboarding is important; it helps new hires to build relationships quickly to feel that they belong. Specifically, Carucci says, new hires, in partnership with their manager, should identify 7 to 10 people (superiors, peers, direct reports, and internal and external customers) whose success they will contribute to, or who will contribute to their success. Then, new hires should craft plans to connect with each of these stakeholders one-on-one during their first year. Carucci explains, “This can be a short meeting over coffee or lunch—an opportunity to learn and ask for guidance.” In addition, building social capital with teammates daily will help to build camaraderie and trust. Therefore, social onboarding should include planned and structured opportunities for socializing with coworkers. For example, one of the best ways to start things off well is to ask a friendly employee on your staff to have lunch with the new hire during his first few days on the job, and to make sure that the new hire knows in advance that this will be happening. Another is to facilitate ice-breaker activities that enable new hires to become known quickly by teammates and for them to get to know their new coworkers, Carucci says.