Orientation and Onboarding: It's Not Just for Newly-Hired Staff - October 2021

Throughputs in Action

Orientation and Onboarding: It's Not Just for Newly-Hired Staff

Submitted by

Anna Herbert, MSN, BA, RN, CPHON
Michelle Swartz, MSN, RN, NPD-BC, CPN
Piper Coleman, MSN, MPH, RN, CPHON, CPN
Michele M. Scott, MSN, RN
Jennifer Saupe, MSN, RN, NPD-BC, CNS

It is often a once-in-a-career opportunity for the nursing professional development (NPD) practitioner to be involved in opening a new patient-care building. This opportunity commenced in 2019 for five NPD practitioners at Cincinnati Children’s Hospital. This core education and training team was tasked with ensuring staff was trained to competently and confidently work in the new building specifically designed for critical care patients. The team utilized the NPD Practice Model to develop and implement a comprehensive, technology-forward, themed training that exceeded staff expectations. With “onboarding/orientation” and “education” as the main NPD throughputs, the team embodied the roles of learning facilitator, mentor, and change agent to develop interactive, team-based education. 

As learning facilitators, it was important to understand the knowledge, skill, and practice needs of the staff orienting to the space. Department-specific needs assessments determined that equipment, technology, and life safety competencies—along with visualization of the entire building, familiarity with individual units, and awareness of workflow processes—must be elements of training. As a way to create a cohesive training environment that included each of these educational needs, the team used a “destination” theme, in which a Destination Ticket, Building Wayfinding Passport, and Department Itinerary were created.

The Destination Ticket set the stage for the training experience. It incorporated the details staff needed to have a successful training experience. The Building Wayfinding Passport was an interactive guide that allowed staff to experience the new building at their own pace. At designated locations, staff obtained a stamp to place in their passport. Additional interactive elements included trivia questions and QR codes that played informational recordings. The Department Itinerary was a two-page document—individualized to each department—that guided staff through the training. The Department Itinerary, along with the Ticket and Passport, were tailored resources that helped provide a learning experience that met the VARK learning styles and promoted active-learning within teams. 

It was essential for the NPD team to effectively function as a mentor to ensure that the orientation to the new building was a success. The core NPD team developed a Facilitator and Superuser Training for department leaders conducting the training on their respective units. In addition to equipment and technology education, the NPD practitioners provided education on coaching and facilitating, as it was recognized that many of the facilitators and superusers did not often teach and could benefit from training. The training included strategies on how to use learning-style principles to engage novice to expert staff, how to incorporate interactive, team-based activities, and how to elicit impactful questions.

The core NPD team also worked in the role of change agent in several ways. First, the team brought positivity and enthusiasm to the orientation, working hard to identify when staff seemed overwhelmed, validating the feelings, and striving to reframe concerns so that staff could focus on their training. Additionally, the core team regularly checked in with facilitators and superusers, talked with staff about their practice changes and outstanding questions, and worked to find answers in real-time. Importantly, the core team also acknowledged that some questions did not yet have an answer. Staff was reassured that their questions were being escalated to the appropriate team or they were encouraged to work with their unit leadership to solve unit-based questions, such as new workflows or processes.

In November 2021, staff will start caring for patients in the new building. Opening a new, state-of-the-art, pediatric critical care hospital building takes vision and expertise from an interprofessional team. It cannot be understated how important it is that the NPD practitioner is part of the team. A hospital building is nothing without its staff. At Cincinnati Children’s Hospital, the NPD practitioner was trusted to ensure those staff members were trained to confidently and competently care for patients in a new space.

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