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Healthcare’s Challenging Relationship Between Onboarding and Employee Retention

Tune Up Your Onboarding Process to Improve Employee Retention
Katarzyna Bia?asiewicz/

The healthcare industry is suffering due to under staffing and low employee retention rates. Healthcare facilities benefit from an employee’s long tenure, but retention is difficult for some facilities. As the baby boomer generation retires and millennials take their place, HR professionals need to find the best employees and keep them. One way to tackle this problem is for Human Resources Departments to invest in a structured onboarding process for new employees. By implementing an onboarding process, organizations will see results: a diverse staff that grows and stays.

Onboarding is the action taken by an organization and management team to support the new hire’s introduction to the organizational culture and provide the necessary knowledge, skills, abilities, and behaviors to be productive employees.

A recent study of a 187-bed community hospital located in Washington, DC reported new hire turnover decreased from 39.1% to 18.4% for hospital and RN staff after implementing a 10-element onboarding program intervention. Once the onboarding process was overhauled, new employees received proper training and support from all levels of management.

What is the ideal timeline for onboarding new employees?

The answer is 1 to 1-and-a-half years, but the first 90 days, what is usually considered the probationary period, is the most important for retention. Many HR professionals have a false belief that onboarding ends on orientation day. To properly integrate an employee into an established culture and ensure sufficient job knowledge, constant education, support, feedback, and performance reviews are required.

A strong correlation exists between onboarding processes and turnover rates and costs, Applicant Tracking Systems usage, and employee performance. Using onboarding will positively affect these variables, which in turn improves employee retention.

Turnover rates and costs

A recent study conducted by the Retention Institution at NSI Nursing Solutions showed a 16.2% annual turnover rate. Healthcare is an industry where the cost of turnover can be detrimental to hospital budgets. The same study also showed RN turnover costs ranging between $38,900 to $59,700. This statistic is only for one position, so this position alone generates millions of dollars annually in turnover costs.

Hospitals and other healthcare facilities are inoperable without the #1 commodity: People. Patients need happy staff to care for them; therefore, facilities need to offer competitive packages and career advancement opportunities because patient satisfaction and patient care are dependent upon workforce stability.

Applicant Tracking Systems Usage (ATS)

A good method to increase employee retention is to streamline the onboarding process by using an electronic Applicant Tracking System.

Recruiters communicate with numerous candidates throughout the process. ATS systems capture the entire onboarding process from tracking employees’ progress to emails and communications. Since all onboarding information is easily accessible, issues are identified easily. HR professionals have the ability to review communications at any time and inform HR staff of any problems.

ATS saves HR staff hours of work, making email generation simple and creating a paperless process. It also develops higher levels of productivity for HR professionals and new employees. More efficient time management allows more focus on developing and implementing human capital strategies.

Employee Performance

An employee’s performance is usually measured using annual performance evaluations. Providing feedback to new employees early during onboarding assists in retaining employees because it engages them to actively participate in fulfilling the organization’s goals. Employees have their own personal goals for their careers. It’s management’s responsibility to align the organization’s goals with the employee’s personal career goals. Set employees up to succeed by providing resources like mentorship programs.

25% of healthcare employees said lack of a mentor makes work more difficult and challenging. Creating mentorship programs will decrease stress on new employees working in high-risk environments because it allows for an open dialogue for feedback and continuous support. Mentors can invest more time in coaching new employees along their career goals and connect them to the organization’s goals by creating short and long-term achievable and realistic objectives.

Retaining employees starts will a great first impression. Onboarding new employees using a structured process gives employees the perception of a well-run organization and will determine early on how long the employee will stay. In addition to first impressions, the benefits of lower overall costs, using an ATS and improving employee performance will lower employee retention to acceptable rates. In healthcare, happy employees equal happy patients.

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About Erica Macon

Erica Macon is a HR Professional with 8 years of expertise in recruiting, compliance and training. Her articles focus on HR trends in recruiting and compliance and have appeared in Nia, an online magazine and Her writing style is consultative yet personable. She works as an Independent HR Consultant for small businesses and startups. To learn more about how her HR knowledge could grow your business, visit her website at

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