ONBOARDING PROCESS GUIDE
WHAT IS ONBOARDING?
Onboarding is a series of behaviors executed by members of an organization to facilitate transforming a chosen candidate into a productive member of the team.
Ideally, it begins well before the employee’s start date and extends for several months to a year or more and involves much more than filling out necessary paperwork and providing the basics of orientation. Done well, onboarding promotes the hire’s sense of belonging and security, understanding of and adaptation to the culture of the organization, team building, strategy formation and personal growth.
WHY ONBOARD?
Effective onboarding:
• Improves productivity by 70%
• Increases likelihood of retention at 3 years by 69%
• Increases early success, task efficiency, and overall performance
• Decreases time to engagement by X%
• Increases a sense of belonging which drives organizational performance
WHO NEEDS ONBOARDING?
All new hires to an organization benefit from strong onboarding support.
Individuals transitioning to a new role within an organization also need onboarding rather than assuming they understand the complexities of their new role and systems. Most importantly following best practices for onboarding Leadership hires, especially physicians, will have particularly high returns to the organization and the hire because of their high impact on the overall performance of the organization.
PHYSICIANS ARE UNIQUELY SUITED FOR ONBOARDING SUPPORT
Unlike CEOs, MBAs and other typical executives, physicians rarely have any formal leadership training. The skill sets which make physicians effective in clinical or research roles are often not the ones most needed in strategically leading an organization.
Physicians are used to being the expert and less accustomed to seeking input from others, building alliances and consensus, and having large gaps in knowledge areas essential to their role such as business finances.
And, they have well-honed strengths. Physicians are smart, have a love of learning, and are driven toward high performance.
ONBOARDING GOALS
PHASE 1: OFFER ACCEPTANCE – THE FIRST 100 DAYS
• Complete new hire paperwork and trainings
• Decrease anxiety about uncertainties of new role.
• Foster a sense of belonging and trust between the hire and the organization.
• Promote understanding and flexible adaptation to organizational culture.
• Foster relationship building
• Clarify job expectations, roles, and measures of success.
PHASE 2: EARLY LEADERSHIP IMPACT MONTHS 3-6
• Support leader in developing leadership voice
• Support leader to Develop Strategy and Direction including early win opportunities.
• Provide access to skill building opportunities.
• Support building partnerships and alliances.
• Establish and pattern of regular feedback loops.
PHASE 3: SUSTAINING LEADERSHIP SUCCESS MONTHS 7-9
• Support the leader in Driving Results
• Celebrate early winds
• Provide midyear feedback on measures of success
• Consolidate understanding of deliverables for the first year
• Ensure regular feedback loops are in plaec
• Support wellbeing
BEFORE THE FIRST DAY
Nurturing new hires soon after the offer is accepted fosters a sense of connection and decreases anxiety about what to expect.
1 Send letter of welcome packet from the leadership team. Include information about the history of the organization, mission, vision, and organizational structure and maps, office address.
Bonus: provide photos and names, short bios of key team members.
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Have hire complete as much employee paperwork in advance as possible.
CREDENTIALING:
• State medical license number
• National Provider Identification number
• DEA
• DHEC
• Medicare number
• Medicaid
• Hospital privileges
• Provider status on insurance panels
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HR REQUIREMENTS
• Benefits
• Tax forms
• Health testing
• Schedule a phot shoot for head shot
• Add bio and phot to Website
• Update Dr. New’s online profile
Identify needs and set up for their needs or provide information about they can obtain.
• Office location
• Keys
• Office supplies
• Computer
• Set up HER login
• Email address
• Prescription pads
• Lab coat
• Medical or surgical equipment
• Business cards
• Name signage
• Welcome gift from the team
Send email announcement(s) introducing new hire to the team and organization. Prep the team for their arrival including background information, role and expectations regarding supporting their onboarding. Provide hire’s contact information so they want to reach out to welcome them.
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Map out the first week. First impressions are lasting so be especially intentional about events for the first day and first week. What impression do you want to give? What adjectives do you want the hire to use about the organization when they talk to their family that night? How can you use the first week to solidify the hire’s impression that they made the right decision in joining your organization? See below on what to include in the first week.
Schedule introductory meetings with key individuals well ahead of time to ensure availability thus avoiding the impression that making time to meet wasn’t a priority. Consider leaders, colleagues from other divisions, team members, community stakeholders.
7 Identify key individuals in the onboarding process. Discuss the role expectations with the potential choice and ascertain level of enthusiasm for participating. Provide handout on the role expectations.
Orientation ambassador: this person manages the orientation schedule logistics and escorts the hire to meetings in the first few days. This greatly reduces the chaos and feelings of insecurity of those first critical days.
Buddy: a peer who is easy to ask logistics questions and can provide daily supportive check-ins for the first month. They communicate unspoken rules and cultural nor ms so can have a strong influence. Choose this person wisely.
Mentor: a seasoned leader who can provide insights regarding career development and the leadership role until the hire establishes their own mentor relationships. Ideally, the mentor is outside of their direct team and knowledgeable about the organization.
Coach: this professional will catalyze the hire’s transformation into an engaged, productive leader
8 Set up their workspace. Having a welcoming ”home” so they can start off feeling organized and cared for. A gift of company swag adds a sense of being a part of the group.
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Pre-populate a calendar with onboarding meetings, standing meetings they will be expected to attend and organization-wide events.
10 Create a list of stakeholders contact information and, if possible, photo and brief bio.
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Have the ambassador reach out the day before start date to make sure hire knows where to meet, what to expect, where to park, what meals will be provided, etc. Answer any questions.
THE FIRST DAY
The value of first impressions cannot be overstated. Set your new hire AND the organization up for success by focusing on positive interactions from Day 1. The first day should feel like a celebration not an obligation. After the extensive and expensive hiring process, the new hire is finally starting, and the next chapter is beginning. Meet them with a smile and a well laid out schedule. Getting acclimated to a new job is a marathon. Don’t wear them out on the first day.
• Remind the team of the exciting news. Tell them when to expect meeting Dr. New
• Consider having team members with frequent contact wear name tags.
• Start with a relaxed meeting of welcome with Dr. New’s leader or a drop-in with doughnuts for a welcome. Name tags with roles are a bonus.
• Have Buddy take Dr. New on a tour. – Include tips about best parking, lunch spots, restrooms, usual meeting rooms. Provide a marked map. Along the way, make joyful introductions.
• Provide lunch for leader or Buddy and Dr. New.
• End day with a debrief of questions and discussion of the rest of the week’s schedule. Use this time to help Dr. New know what to expect, when the days will be done, and to again welcome them to the organization.
THE FIRST 90 DAYS
Most organizations stop their onboarding process just after the first week greatly underestimating how much support a new physician needs when they transition into a new job. Just because they are smart and have been practicing medicine already does not mean they have awareness of what it takes to be effective and efficient in this new role. Physicians are trained to present themselves as confident and competent which sets them up as particularly at risk for “imposter syndrome” in which they feel secretly incompetent, confused and discouraged. Too afraid of this being discovered, they avoid asking questions which perpetuates the cycle of lack of support. Assuming they know nothing and teaching them how this organization handles each situation fosters learning and letting go of potentially costly assumptions.
The first few weeks are the critical step in helping Dr. New settle in and establish early relationships. This provides psychological safety for both Dr. New and the team by reducing uncertainty, increase a sense of being valued and beginning the bonds toward trust that will be essential for open communication. 93% of respondents to Deloittes 2020 Global Human Capital Trends survery stated that a sense of belonging drives organizational performance. This is also the time to create alignment of goals and clarify assumptions about what is expected.
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Create and review a 30-60-90 day plan including deliverables, milestones and deadlines. Include action steps related to key tasks of relationship building, understanding about the organization’s current functioning and culture.
Identify an early project with a high degree of success.
2 Clarify job roles and responsibilities fully including identifying assumptions. Alignment of expectations early greatly enhances job satisfaction and performance.
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Delineate compensation formula and promotion plan.
Introduce the company culture including the mission and values. Discuss how their role impacts the mission. Lack of understanding about and failure to adjust to the culture of an organization is the primary factor in derailment of a new leader. Help Dr. New identify unwritten rules, behavioral expectations unique to the organization. Provide prompt early feedback to help them adapt their style to the new culture.
5 Assign someone to review procedures and standards in each of Dr. New’s roles.
6 Initiate training of technology platforms and assign a contact person for assistance with questions and further training as needed. Review policies about social media, computer usage etc.
• Arrange for hospital tour
• Add Dr. New to the call schedule
• Determine surgery and clinic schedules
• Review practice’s coding and documentation process
• Review fee schedule and collection procedures
• Review front desk operations, appointment scheduling, check-in and check-out process
• Educate Dr. New about medical resources in the community
7 Facilitate networking and team building opportunities including key leaders in other parts of the organization.
• Provide information about local, regional and national professional society meetings
• Invite Dr. New to join leaders at lunch, professional development opportunities, and informal gatherings.
8 Make sure the coach, buddy and mentor relationships have been established and are a good match.
9 Set up monthly feedback meetings to foster early growth and structure open communication. Recognize and celebrate any achievements or milestones, allow for questions, serve as an accountability check on deliverables.
MONTHS 3-6
This phase of onboarding centers on supporting the new leader to have early impact through strategy development, professional development of their own skills and the talents of their coworkers, and enhancement of strategic relationships.
• Create expansion of action plan for the rest of the year. Define deliverables, timelines, milestones and measures of success.
• Key areas of professional development for Dr. New are likely to be leadership skills, team building skills, collaboration and role specific skills. Research shows that employee retention and satisfaction are greatly increased when employers invest in their career.
• Gather and provide regular feedback on growth opportunities, achievements, alignment with vision, and leadership behaviors.
• Identify resources to support further progress.
MONTHS 7-9
Dr. New is now influencing others and driving results toward measurable, sustainable growth.
• Continue regular feedback meetings.
• Create opportunities to highlight the impact of their efforts with attention on the collaborative efforts.
• Model establishing accountability by directly assessing progress toward deliverables.
• Provide opportunities for expanded collaborative impact.
