Open Forum

Hello all,
​We are looking into re-vamping our orientation process for ambulatory care clinical staff, anyone have an orientation/onboarding program that they have implemented and are having success with?
Thank you,
Jessica

------------------------------
Jessica Skelton MSN, RN
Nurse Clinician
VCU Health
Richmond VA
(804)316-5812
------------------------------

I'm also interested in the responses you receive.

------------------------------
Patricia Parrish, MSN, RN, NE-BC
Ambulatory Nurse Manager - Quality and Safety
Augusta University Medical Center
Augusta, Georgia
706-829-3863
------------------------------

Several years ago we bought the resource Ambulatory Care Nursing Orientation and Competency Assessment Guide  from AAACN, and have found some great tools for planning orientation and competency assessments.  We onboard staff mostly at the clinic level, but have a class twice a month that covers key topics and reinforces following policies and procedures and identifies resources for onboarding employees.

------------------------------
Lisa Duncan, DNP, MBA, RN, AMB-BC, CIC, NEA-BC
VP, Regulatory and Compliance
Family Health Centers of San Diego
------------------------------

Lisa, this is a great resource! Thank you for sharing.
Jessica​

------------------------------
Jessica Skelton MSN, RN
Nurse Clinician
VCU Health
Richmond VA
(804)316-5812
------------------------------

Original Message:
Sent: 06-23-2022 13:16
From: Lisa Duncan
Subject: Onboarding New Team Members

Several years ago we bought the resource Ambulatory Care Nursing Orientation and Competency Assessment Guide  from AAACN, and have found some great tools for planning orientation and competency assessments.  We onboard staff mostly at the clinic level, but have a class twice a month that covers key topics and reinforces following policies and procedures and identifies resources for onboarding employees.

------------------------------
Lisa Duncan, DNP, MBA, RN, AMB-BC, CIC, NEA-BC
VP, Regulatory and Compliance
Family Health Centers of San Diego
------------------------------

Jessica,

Our organization has been using a competency based orientation packet that has little guidance as to when specific skills should be learned with minimal structure for a preceptor to guide the orientee. We are now moving towards a tiered skills acquisition model (TSAM) that we call the onboarding pyramid. The pyramid is structured similarly to Maslow's hierarchy of needs but with different level of skills. Each level of the pyramid represents a tier in the onboarding packet. Due to the multiple ambulatory care services, the pyramid is specific to the role (i.e. medical assistant, RN) and the skills are those that anyone working in any ambulatory location should know. To address the clinic service line needs, we have included a document that lists the specific tasks, skills, duties that apply to each clinic service. This method allows the orientee to master skills identified in each tier by incorporating structured learning at the right time and opportunity for weekly evaluation of progress with the preceptor. The TSAM also provides the preceptor with guidance on what skills to teach and at what point of the orientation process. This model is not time based but rather on meeting competency before moving into the next tier. In support of re-vamping your onboarding process, I would also suggest looking into the Ambulatory Care Nursing Orientation and Competency Assessment Guide from the AAACN and The Ultimate Guide to Competency Assessment in Health Care by Donna Wright.

------------------------------
Heide Brooks MSN RN
Ambulatory Nursing Practice Specialist
Kootenai Health
Coeur D Alene ID
(208)625-3867
------------------------------

do you have an example of the MA LPN or RN pyramid that you'd be willing to share?

------------------------------
Carrie Lemke DNP RN NPD-S BC
Advocate Aurora Health
Denmark WI
(920)655-7795
------------------------------

Original Message:
Sent: 06-24-2022 11:12
From: Heide Brooks
Subject: Onboarding New Team Members

Jessica,

Our organization has been using a competency based orientation packet that has little guidance as to when specific skills should be learned with minimal structure for a preceptor to guide the orientee. We are now moving towards a tiered skills acquisition model (TSAM) that we call the onboarding pyramid. The pyramid is structured similarly to Maslow's hierarchy of needs but with different level of skills. Each level of the pyramid represents a tier in the onboarding packet. Due to the multiple ambulatory care services, the pyramid is specific to the role (i.e. medical assistant, RN) and the skills are those that anyone working in any ambulatory location should know. To address the clinic service line needs, we have included a document that lists the specific tasks, skills, duties that apply to each clinic service. This method allows the orientee to master skills identified in each tier by incorporating structured learning at the right time and opportunity for weekly evaluation of progress with the preceptor. The TSAM also provides the preceptor with guidance on what skills to teach and at what point of the orientation process. This model is not time based but rather on meeting competency before moving into the next tier. In support of re-vamping your onboarding process, I would also suggest looking into the Ambulatory Care Nursing Orientation and Competency Assessment Guide from the AAACN and The Ultimate Guide to Competency Assessment in Health Care by Donna Wright.

------------------------------
Heide Brooks MSN RN
Ambulatory Nursing Practice Specialist
Kootenai Health
Coeur D Alene ID
(208)625-3867
------------------------------