06/07/2017. Objectives. Background. What is onboarding? New employee now what? Interprofessional and Team-based Onboarding

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1 Objectives Explain the role of preceptor in onboarding and team building Interprofessional and Team-based Onboarding Michelle Mahaffey Harmon, PhD, RN Henry Ford Macomb Hospital Describe the integration of new employees into interprofessional teams Identify positive and negative factors associated with interprofessional team building Background Issues with providing high quality care to patients have become a challenge for healthcare systems. Lack of collaboration among care providers continues to plague our care delivery system with poor quality outcomes. Research has shown that when a collaborative practice exists between nurses and physicians, patient outcomes improve. The Institute of Medicine (2010), recommended for nurses to take on an active role in facilitating the lead in collaborative practice Many managers do not understand the need for having a collaborative practice environment on their units. Managers need tools to assist them with improving interprofessional collaborative practice starting with Onboarding of new employees What is onboarding? A process that integrates new hires into the organization (Swihart & Figueroa, 2016) Begins with determining staffing needs Includes the candidate selection Facilitates the employee s path through orientation New employee now what? The manager should complete the following tasks: A welcome letter is sent to the new hire A preceptor is assigned A coach/mentor/buddy has been identified An announcement is placed in the staff lounge about the new hire A detailed work schedule is sent to the new employee A list of orientation items that need to be completed with deadlines is developed for the new hire [New Hire Name] [Address] [City, State Zip] Dear [New Hire], Congratulations and thank you for choosing to join our team at! I would like to extend a warm welcome to you from all of our staff as you become a member of [department / unit name]. Your preceptor will be, and your mentor/coach/buddy is. Remember during your orientation period, you will be following the schedule of your preceptor. Your first day Please come to my office at least 10 minutes prior to the start of your shift so that I can show you the locker room and assign you a locker where you can leave your belongings. If you have any questions, please do not hesitate to contact me either at the number or listed below. Again, on behalf of unit, welcome and we are excited you decided to join our team! We look forward to working together with you in serving our patients and we are confident that you will make valuable contributions to the team. Sincerely, [Hiring Manager Name & title Phone # & ] Sample Welcome Letter for New Hire 1

2 Announcement Letter to Staff [Hospital Information and logo] [Date of announcement] Preceptor s Responsibility in Onboarding New Employees Dear [department name] team: I am delighted to announce that [new employee s name] is joining our unit as [job title of new employee] on [start date]. [new employee s name] will be working here as a [job title]. During the onboarding process, [name of Preceptor ] will be assigned as a preceptor to [new employee s name] to assist with orientation. Many of you will be involved in assisting [name of preceptor] in the orientation process for our new employee. We all will be working to assist [new employee s name] to become an engaged and productive member of our work team. Please make a point of welcoming [new employee s name] to our unit on [his / her] first day and do everything you can to make [him / her] welcome. Sincerely, [Hiring Manager name & title] Ensure that new hire moves smoothly from orientation to the unit Role model Socializer Educator Servant leader Provide constructive feedback Introduce new employee to the work culture and norms of the unit Are responsible for completing the new employee checklist Preceptor s Checklist for New Hires BEFORE NEW TEAM MEMBER STARTS Get a copy of unit handbook (if applicable) Arrange for welcoming items or events for the new hire (door sign, unit breakfast/lunch, etc.) Ensure schedule has been completed by manager for the new hire WEEK ONE Meet and greet on day one with new hire Tour areas of the unit and organization Identify workspace area Shows new hire locker room, break, room etc. Be available to answer questions Assist the new hire with understanding of acronyms typically used in your unit Assist new hire to get settle into work flow Introduce new hire to interprofessional team members working on the unit DURING THE REMAINDER OF THE EIGHT WEEKS Meet informally with new hire to check if she/he is transitioning appropriately Review the checklist to ensure any problem areas are addressed in a timely manner AT THE END OF THE EIGHT WEEKS Preceptor relationships may continue informally as colleagues Preceptor: Discusses team overview with new hire and their role on the team Introduces new hire to the interprofessional team on the unit Explains the influence of the interprofessional team on patient outcomes Five Team Building Stages Forming Preceptor s role is to introduce the new hire to the team leader, and existing members Important to let the new hire know what the team goals and tasks are and each role others play on the team At this point, everyone is demonstrating polite behaviors among the group For new hires, team norms are not quite understood Storming Stage where members begin to feel more at ease with the group are comfortable with voicing their views but now there is a new member Competition among the group for various team roles and conflicts might arise Disagreements begin to surface regarding goals and how to accomplish related to blurred boundary lines from existing members Goal of the preceptor is to assist the new hire with the ease of transitioning into the group 2

3 Norming New team member is starting to be integrated into the team Team begins to agree on norms and expectations Preceptor encourages the new hire to voice ideas, opinions etc. Trusting relationships are developed Preceptor is directly involved in decision-making and overseeing new hire duties and performance Performing At this point the new hire is fully integrated into the team Cohesiveness as been built; everyone understand what s expected Trust has been established; supportive of each other Preceptor has moved from decision-maker to evaluator of new hire s performance Adjourning New hires reach this stage at the end of onboarding and is fully integrated into the interprofessional team The majority of orientation activities are completed and competencies have been validated by the preceptor The new hire feels comfortable in their role, and responsibilities as a team member After learning the five stages of team building, nurse managers and preceptors work with new hires to: Build trust Anticipate how difficult change might be for other team members Allow time for new hires to adapt to their roles and responsibilities Preceptors and Managers should incorporate the following into their onboarding program for new hires: Clear goals & expectations Clarification of all team members roles Open & clear communication Encourage participation in shared governance activities Discuss conflict management & zero tolerance for bullying etc. Facilitate critical thinking and problem-solving for new team members Discuss unit diversity as it relates to patients, staff and others in the workplace 3

4 Factors Associated with Successful Team Building Negative Factors Associated with Team Building New Hires Must be familiar with their position descriptions and expectations. Need to learn about their new team members and understand the formal and informal unit and organization boundaries. Value one another s contributions. Differentiate roles and responsibilities of team members and support staff Practice interdisciplinary and interprofessional communication that are critical behaviors for teams providing patient-centered care. When people withhold their ideas, observations, or questions, they become a potential risk to patient safety. Problem issues with team building include blaming turf protection mistrust inability to directly confront issues. New employees must learn to deal effectively and practically with difficult situations and work effectively with existing team members. Promoting Interprofessional Collaboration Managers promote interprofessional collaboration by incorporating the following practices within their units Assigning mentors to new hires Making certain they utilize experienced people as preceptors Setting the tone for open communication Spending time meeting with both new hire and preceptors Incorporate interprofessional rounding into the new hires onboarding/orientation Have the preceptors review patient care needs/goals addressing areas how the interprofessional team might impact patient outcomes New Hire Scenario Josh is a new graduate nurse hired into the health system. You have sent his welcome letter and posted the announcement of his employment in your staff lounge. His hospital orientation has been completed and he has started on your unit and is engaged in the onboarding process. What steps should the preceptor and mentor follow to ensure that Josh is fully acclimated to the unit and interprofessional team? Onboarding Challenges Questions Josh is experiencing some challenges in his role. It s his first job as an employee He has an introverted personality and lacks confidence and his preceptor has no empathy Josh and his preceptor haven t been able to form a bond During interprofessional rounds, Josh s preceptor provides the information while Josh just listens; and no one has asked his opinion Do you think the manager plays a role in acclimating Josh to the unit? If so, what? What role does Josh have in building a relationship with his preceptor? How can the interprofessional team assist in building confidence in Josh? What could the preceptor do differently during rounds to increase Josh s participation? 4

5 Summary Remember, effective onboarding requires for all to play a part in engaging new hires into the workplace Managers need to be in the forefront for establishing this practice within their units 5