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Orientation: To customize or standardize? - Summer 2015
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By Donna Ecclestone, FASPR, Associate Director, Physician Integration/Onboarding, Duke University Medical Center, Durham, NC

When it comes time to create an orientation itinerary for new providers at your organization, there are a couple of options: Group training and/or one-on-one meetings. At Duke, our initial approach was to personalize each new physician’s orientation with customized itineraries and one-on-one meetings, but recently our department has been transitioning to more group orientations when the onboarding volume is heightened. However, the question remains, what is the best practice? Let’s dive into the pros and cons of each approach.

Onboarding programs are typically launched at an organization based on the concept of creating a “standardized approach” for integrating new physicians into the organization. This initiative typically lends itself to the concept of group orientations to ensure that everyone hears or receives the same message. For instance, in a number of organizations, compliance, organizational culture, meaningful use, and benefits overviews are often provided in group orientations. Group training offers cost sharing benefits to the organization and networking opportunities to the new physician. It can also foster long-term collegial relations and set referral patterns among new staff. However, is the message truly getting through in a group setting? The answer: Sometimes. Great presenters can make group settings work by being interactive and engaging, even if the material may be dry.

Creating orientation itineraries exclusively with one-on-one meetings allows the onboarder to address specific onboarding needs for the new physician in order to ensure they have what they need to be successful. For instance, allowing a new surgeon to meet one-on-one with the Director of Peri Op Services, scheduling staff, and the nurse manager for their service is a great way to start the new physician’s career off with engagement and teamwork. Typically, the new physician appreciates the time that is shared and the one-on-one focus. However, this attention may be difficult to arrange, inefficient and time consuming when you have many new incoming faculty.

Many organizations are also incorporating online training for onboarding. Banner Health’s approach is a great example of how this is utilized. While this concept may be well received by the Millennial / Gen Y group of physicians, who want a fast pace and processing, other generations may be disenchanted with this web-based approach, especially if they have limited computer skills.

To find out more about what is being commonly used in the industry, I surveyed members of the Onboarding and Retention (OAR) Chapter of ASPR and posed the questions below. Keep in mind, this survey is not based on scientific method, but the results were very interesting.

What type of orientations on global topics (compliance, IT, corporate culture, etc) do you offer to your new providers as part of their initial orientation to your organization? (ie: compliance, corporate culture, IT, etc?)

Answer Choices Responses
Group orientations 13
One-on-One meetings 10
Online training 4
Combination of group and one-on-one meetings 13
Total 40

If time was not an issue, what setting do you feel is the best learning environment for new providers?

Answer Choices Responses
Group orientations 7
One-on-One meetings 17
Online training 0
Combination of group and one-on-one meetings 17
Total 41

Do your organizational leaders meet with your new providers during their first few weeks?

Answer Choices Responses
Yes 30
No 11
Total 41

When is the first time, on average, that you “check in” with the new provider after they start?

Answer Choices Responses
First Day 15
Second Day 3
First Week 9
Second Week 2
First Month 10
Total 39

What we can conclude from this random sample is this:

  1. Orientation methods vary. Most respondents use group orientation or a combination of group and one-on-one orientations as their format.
  2. Ironically, respondents feel equally that group and one-on-one orientations are the best learning environment, if time was not an issue. These are also the common methods most respondents are currently using.
  3. Almost 40% of the respondents from OAR organizations have their organizational leaders meet with the new providers on the first day. This commitment of the leaders’ time sets the stage for retention.

In conclusion, organizations are using various methods to deliver their initial orientation messages to their new providers. There is no one way to do it. We have found that organization leaders’ commitment to new providers as well as consistent check-ins with new faculty help reduce concerns (and turnover) and will foster their success. Remember, however, orientation is only a small piece of the larger concept of onboarding, which needs to continue over a period of six months to a year for maximum retention success.

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