Using Needs Assessments to Individualize New Hire on Boarding for Home Health Nurses

PODCAST: Customizing the Employee Orientation Process for Optimal Benefit Conducting employee orientations that are a good fit with the organization and with new hires is challenging. A home health agency in La Mesa, California was considering ways to address the organizational challenges of onboarding newly hired registered nurses who are positioned to serve a majority of geriatric patients in the San Diego County.

For the project that is central to this discussion focused on a total of five full-time nurses who were newly hired to home health within the last six months to a year. Sharp Home Healthcare experienced similar challenges to those described for the home health agency located in La Mesa.

Specifically, the challenges that Sharp Home Healthcare needed to address included: 1) Keeping newly hired nurses interested and preventing or decreasing turnover rates; 2) properly providing a well-designed orientation program; 3) training the skills needed for the home health nurse working in the community; and, 4) training the newly hired nurse to be a case manager and manage a patient caseload. New hire employee orientations are important on several different levels. An employee orientation offers the first impression of the organization's management.

Having a structured yet flexible new employee orientation process can eliminate problem of too rushed on-boarding of new hires, while enabling customization to meet diverse employee needs. By using a unique needs assessment tool and process to individualize new employee orientations, it becomes possible to meet the employees at their levels of training and experience. When a new hire orientation process is not well conceived or well implemented, a range of undesirable outcomes can emerge, including diminished quality of patient care and job satisfaction.

The needs assessment process for developing new employee orientations goes a long way toward ensuring a good fit between the employee, the position, and organizational values. In this regard, the needs assessment for new hire orientation supports the ability of Sharp Home Healthcare to keep newly hired nurses interested and prevent or decrease turnover rates. (Describes an organization facing similar challenges.

1) The main driving force that supports the use of the needs assessment tool for new hire employee orientation is to provide a guide for the new employee introduction process that accomplishes two important goals: 1) Provide job expectation information to the new employee; and 2) enables the organization to learn about its new employees in depth. The resisting forces that influence the development and implementation of the needs assessment process within an organization are the primarily those associated with the use and availability of resources.

Time and expense are commonly associated with new employee recruitment and hire processes, and these constraining forces continue to impact the organization even after hire decisions have been made. In addition, the individuals within the organization who are responsible for implementation of the change effort to establish the new hire orientation have their own reasons and rationales for resisting the modifications to their established approaches and off-the-cuff problem solving.

Clearly home health agencies, such as Sharp Home Health, need to provide training to develop skills needed for the home health nurse working in the community, and the needs assessment helps them do just that. (Evaluates the organization's driving and resisting forces to change. 2) Many stakeholders were engaged in the development stage of the needs assessment tool and process. This was a crucial internal aspect of the planning and development since the roles of stakeholders were identified or clarified in the process.

A fundamental internal challenge that the needs assessment tool and process met was an enhanced ability of the organizational leaders to recognize how well the newly hired nurses understand the home health process, and their roles as case managers and educators. A menu of qualitative and quantitative data gathering methods are appropriate for the needs assessment process, including: Open-ended and closed-ended questions, diverse Information gathering, surveys / questionnaires, interviews, observational studies, and focus groups.

By the end of the new employee's orientation program, the new staff member will be able to identify and implement evidenced-based interventions, and utilize appropriate health services by providing quality patient care. Through this process, the health resources allocated for home care and health improvement(s) can be maximized. (Explained how the organization addressed internal and external challenges. 2) Home healthcare agencies in the U.S. face rising demands for health care. The needs assessment tool is expected to achieve substantial organizational and individual goals. For example, the needs.