~~~ RN New Hire Onboarding Program ~~~ Coming 2019

PURPOSE

Support the experienced, newly employed nurse gain knowledge, skills, and behaviors needed to become an effective team member 

in the new environment.  


Integrate the new nurse into the hospital and its culture while continuing the nurse’s development as a professional nurse.


* Improve RN Recruitment *

* Decrease Turnover *

* Decrease Overtime & Bonus Pay *

* Decrease Dependency on Contract Labor *



Why New HIre Onboarding?

GOALS

Prepare the Newly  Employed Nurse to:

  • Demonstrate effective clinical decision-making skills in the new environment
  • Function as an equal partner with professional colleagues in the patient care team
  • Incorporate research-based evidence into practice
  • Provide clinical leadership in improving patient care
  • Formulate an individual plan for continued learning and professional development

PROGRAM COURSES

  • Clinical Competence
  • Clinical Competency Validation with  Bedside Competency Sign-Off 
  • Workplace Culture Bridge Toolbox
  • Bridge Competency Validation
  • Home Unit Coordination
  • Clinical Leadership / Quality Improvement Project

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Course Content

Clinical Competence

Patient and Employee Safety 

Medication Administration 

Documentation  

General Patient Care 

Genitourinary System 

Gastrointestinal System 

Ortho System 

Neuro System 

Endocrine System 

Integumentary System 

Cardio-Vascular System 

Respiratory System 

Lymph & Immune System 

Behavioral Health


Clinical Competency Validation

Key skills, identified from the Clinical Competence Course and from hospital and unit needs, are used to create Clinical Competency Validations.


Checking off competencies may occur anywhere there is an internet including at the bedside and in a simulation lab by using the COS Bedside Competency Sign-Off.  


Competency progress may be viewed at any time on the Clinical Competency Dashboard by the Learner, Preceptor or Mentor, Manager, Onsite Coordinator, Nurse Leadership, and COS Faculty. 


Using the Clinical Competency Dashboard supports early intervention for problem solving and opportunities to praise and encourage wins.

Workplace Culture Bridge Toolbox

Integrity & Ethics

Health Policy & Regulatory Frameworks

Healthcare Business & Finance

Role Transition & Self Care

Workplace Acclimation & Organization

Systems Theory, Thinking & Design 

Change Management

Communication 

Research & Critical Thinking

Patient Care & Education 

Case and Care Management 

Quality & Culture of Safety 

Teamwork & Leadership Skills    

Career Pathway Development

Bridge Competency Validation

Key Competencies for Workplace Culture Bridge Toolbox & Hospital-Specific Competencies. 

 

Bridge Competency Validation begins with a self-assessment at the beginning of the Program and is completed as one of the last activities at the end of the 12 months. 


Competency progress may be viewed at any time on the  Bridge Competency Dashboard by the Nurse Learner, Preceptor or Mentor, Manager, Onsite Coordinator, Nurse Leadership, and COS Faculty. 


Using the  Bridge Competency Dashboard  supports early intervention for problem solving and opportunities to praise and encourage wins.

Home Unit Coordination

Hospital and Unit Specific Education.


Clinical Competence Course & Clinical Competency Validation Course customized with Hospital and Home Unit Education Material.


Workplace Culture Bridge Toolbox & Bridge Competency Validation customized with Hospital and Home Unit Education Material.

Innovative Cloud-Based Program Structure

Clinical Leadership / Quality Improvement Project

The Clinical Leadership / Quality Improvement Project supports development of critical thinking and clinical reasoning skills. 


It provides a framework for exploration and continuous, lifelong learning. 


The excitement of finding and sharing an improvement for patient care or for the quality of life for colleagues on your own unit can be the impetus for a life of contribution in nursing. 

? Why ?

Why an RN New Hire Onboarding Program?

Driven by the danger of trying to provide patient care with too few nurses and weary from calling all day to fill vacancies on the schedule despite paying overtime and bonuses and using contract labor, Chief Nurses, Chief Financial Officers and Chief Executive Officers nationwide are searching for ways to recruit and retain nurses.


Unfortunately, many hospitals are also struggling with a shortage of staff who can support the education and transition of newly employed nurses. And, current research suggests that successful onboarding is a continuous process, not an event. 


These problems are exacerbated in many rural mid-sized and smaller hospitals where recruitment and retention can be particularly challenging and their older, experienced staff are retiring.


For many nurses, the job market is increasingly wide-open. According to the Bureau of Labor Statistics, the number of job openings for nurses will be 1.09 million by 2024.


While every hospital has an Orientation for its new nurses, few have Onboarding Programs structured 

and staffed to meet the complex demands of transitioning and developing the new hire.  

Therefore, they are not achieving the desired outcomes. 


The COS RN New Hire Onboarding Program is based on recommendations and evidence gathered over 10 years by the Institute of Medicine (now the Health and Medicine Division); the Joint Commission; National Council of State Boards of Nursing; and the Robert Wood Johnson Foundation. Those findings were complemented with many years of experience by the COS leadership developing and implementing successful recruitment and retention programs including educational programs for new nurse hires. 


Designed to engage the newly employed nurse and reduce the time it takes to develop proficiency in the new culture and role, the RN New Hire Onboarding Program serves as a key strategy in attracting and retaining talented nursing staff to meet your needs.

Potential Benefits

1. Improved Recruitment

A branded, structured, evidenced-based program that meets the needs for transitioning into your hospital and its culture is appealing to the nurse who is aware of options and challenges in the workplace.


2. Decreased Turnover

Nurse turnover has risen to 16% (Lippincott, 2017).  While some turnover is expected, research suggests onboarding leads to sustained staff engagement.


3. Labor Cost Savings

  • $22,000 to $64,000 - cost of replacing one RN (RWJF, 2018).
  • Overtime to cover vacant shifts
  • Bonus to cover vacant shifts
  • Contract Labor

4. Improved Reimbursement

Decreased patient transfers due to 

lack of staffing.


5. Improved Staff Satisfaction

Improved nurse satisfaction.

Improved resiliency with adequate staffing.

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Uniquely designed Transition-To-Practice

Innovative Program Structure

COS New Hire Onboarding Program is a structured, guided, 12 month offering. Its evidenced-based curriculum is designed to support the newly employed nurse’s integration into the hospital and its culture. To be most respectful of time and resource constraints, a new Program begins each week.


While the amount of time the individual nurse needs to complete the Program will vary, general expectations are:


During the first 6 weeks, the Nurse Learner completes 12 hours per week of Program activities including Cohort Web Conferences every 2 weeks. Work on assigned competencies begins. The remainder of work time is spent on the unit with the Preceptor learning about the work of the unit, getting to know colleagues and beginning to care for patients.  Cross Departmental Experiences may begin during this time and will continue throughout the Program.

 

During weeks 7 - 12, the Nurse Learner completes 2 hours per week of Program activities including Cohort Web Conferences every 4 weeks. The remainder of work time is spent on the unit with the Preceptor, caring for patients, completing Clinical Competency Validation and beginning work on Bridge Competency Validation.


For the remaining 9 months, the Nurse Learner completes 1 hour per week of Program activities including Cohort Web Conferences every 4 weeks. The remainder of work time is spent in patient care. 

The Clinical Leadership/Quality Improvement Project is completed. 

The nurse continues to be shepherded through the culture transition by COS Faculty and onsite support staff.

Activities Throughout the Program

  • Learning Module Completion 
  • Cross Departmental Experience
  • Competency Simulation   
  • Competency Validation with Bedside Competency Sign-Off
  • Journaling 
  • Cohort Web Conferences 
  • Virtual Office Hours
  • Coaching/Emailing 
  • Clinical Leadership / Quality Improvement Project 

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Blended Onsite & Online Learning

COS RN New Hire Onboarding Program is a Blended Learning experience with both onsite and online education and support. 


COS provides structure, curriculum, learning modules, competencies to be completed, and continuous interaction with newly employed nurse, Unit Manager, Preceptor, Mentor, Onsite Coordinator and other key onsite players. 


COS Faculty coach continually by regularly responding to email and by posting Virtual Office Hours each week and as needed. Support is available throughout the 24 hour day, weekdays and weekends.


Onsite, the nurse is supported by the Unit Manager; a Preceptor who functions as role model, educator, facilitator, and evaluator; and a Mentor. The Preceptor and Mentor complete COS Development Courses and are supported throughout their experience by COS Faculty. Monthly Preceptor Cohort and Mentor Cohort Web Conferences are hosted by COS Faculty for continued development and debriefing. 


Key to Program success is the Onsite Coordinator, a nurse leader, often a nurse educator, who is the hospital’s COS liaison. 

COS leadership is available to the Onsite Coordinator to discuss any aspect of the program.

~~~ Cloud-Based Platform ~~~

COS innovative Cloud-Based Platform allows us to provide programs that are cost-effective and easily client-customized. This makes Blended Learning easy, flexible and smart.


Maximum flexibility and mobility enable Learners to complete learning assignments in their own time, at their own pace, and anywhere the web is available. 


Our platform supports all mobile devices and enjoys industry-leading up-time. It is accessible regardless of time of day or day of week.


The Learners’s progress can be viewed at any time by the Learner and all persons involved in the learning experience. 


All COS Learners may create a Professional Portfolio to document COS coursework, other educational achievements, certifications, personal committee work, research involvement, professional organization involvement, and volunteer work.  The cloud-based document is available indefinitely.


This full support for Competency-Based Learning coupled with actionable learning analytics, supports maximum productivity for the Learner and all persons supporting the nurse learner.

Learn about Cloud-Based Professional Portfolio

Competency-Based Learning Dashboards

Designed to support Competency-Based Learning New Hire Onboarding Program Dashboards are available online for review at any time.


Nurse Learner progress and outcomes available for review include:

  • Confidence
  • Competence
  • Mastery of the Job
  • Ability to Organize and Prioritize
  • Satisfaction
  • Engagement
  • Bedside Leadership
  • Course Progress
  • Competency Completion


COS works with hospital leadership to provide data to trend program impact including:

1.     Organization Data

  • Recruitment
  • Turnover
  • Overtime
  • Bonus Pay
  • Contract Labor

2.     Clinical outcomes

  • HARMS
  • HCAHPS