Physiological Nursing, University of California San Francisco School of Nursing, San Francisco, California.
Division of Geriatrics University of California, San Francisco Health, San Francisco, California.
J Am Assoc Nurse Pract. 2023 Apr 1;35(4):265-271. doi: 10.1097/JXX.0000000000000847.
The return on investment for onboarding programs and their effect on attrition and engagement within health systems across the United States are unclear.
The existing onboarding program for nurse practitioners (NPs) and physician assistants (PAs) at a hospital on the west coast was varied and lacked a clinician focus. A structured onboarding program was created to standardize their entry to our workforce.
A needs assessment was completed with a stakeholder focus group, for which an onboarding curriculum was then created. Participants completed presurveys/postsurveys during the data collection period as the primary outcome. A Plan-Do-Study-Act approach was used to revise session content and improve participant experience. Onboarding costs and attrition were tracked as secondary outcomes.
From July 2017 through June 2019, newly hired NPs and PAs were invited to participate in the program. Six quarterly cohorts attended five in-person 2-hour onboarding sessions over 12 months.
One hundred twenty-nine eligible NPs and PAs completed an anonymous pre/post Qualtrics survey. The aggregate responses were significantly improved using Fisher exact test. Measured onboarding value was not significantly changed. Mean pre-onboarding attrition was 10.3% compared with 4.5% for onboarding participants. The annual cost for onboarding participants was $63,470 versus $256,826 as the estimated mean cost of one separation within their first year.
Workforce engagement, standardized knowledge, and participant attrition revealed an improving trend with this structured onboarding program. The investment to formalize onboarding newly hired NPs and PAs was modest, and the findings suggest that an onboarding program has financial and engagement merit.
在美国，入职培训计划的投资回报及其对卫生系统人员流动率和参与度的影响尚不清楚。
西海岸一家医院现有的护士从业者（NPs）和医师助理（PAs）入职培训计划各不相同，且缺乏以临床医生为重点。为了规范他们进入我们劳动力队伍的方式，创建了一个结构化的入职培训计划。
通过利益攸关者焦点小组进行需求评估，然后为其创建入职培训课程。在数据收集期间，参与者完成了入职前/入职后调查作为主要结果。使用计划-执行-研究-行动方法来修订课程内容并改善参与者体验。入职成本和人员流动率被跟踪作为次要结果。
从 2017 年 7 月至 2019 年 6 月，新聘用的 NPs 和 PAs 受邀参加该计划。六个季度的学员参加了五个为期 2 小时的现场入职培训课程，为期 12 个月。
129 名符合条件的 NPs 和 PAs 完成了匿名的 Qualtrics 入职前/入职后调查。使用 Fisher 精确检验，总体反应显著提高。测量的入职价值没有显著变化。入职前人员流动率平均为 10.3%，而入职参与者为 4.5%。入职参与者的年度入职成本为 63470 美元，而第一年估计平均离职成本为 256826 美元。
员工参与度、标准化知识和参与者离职率显示出这种结构化入职培训计划的改善趋势。正式化新聘用的 NPs 和 PAs 入职培训的投资是适度的，调查结果表明入职培训计划具有财务和参与度的价值。
