One size fits none…

By Steve MacArthur, Hospital Safety Consultant

This week is looking to be somewhat brief in scope as I gather some thoughts and pose a question (if you feel compelled to engage in this as discourse, please reach out to me at – I’m keen to hear your thoughts).

A week or so ago, I was speaking with my wife (she’s a nurse manager at an acute care hospital) about the challenges of onboarding staff quickly, but effectively, particularly when you are bringing on staff who are perhaps not as experienced in the environment to which you are orienting them. Certainly, there are certain basic skills that would be desirable (depending on their job), and may be present, but how do you identify which expectations might need to be unlearned (as you have probably figured out, standards of practice, etc. in healthcare aren’t particularly standardized)?

And then you bring in what is rapidly becoming the norm—traveler staff. Clearly, from an economic perspective, we don’t have a lot of time to get the travelers up and running—and it may well be that some of the elements that would normally happen during the department-level orientation process aren’t making their way to the collective as the focus becomes one of “hitting the ground running" for new staff.

Historically (and this is not always the case, but I suspect it is more true than not), the “safety” part of orientation has tended to diminish in time allotted as HR-related stuff and there’s tended to be something of a shift to department-level orientation as the “place” for the sharing of safety knowledge and expectations. But what if folks are starting to “do their jobs” because there are patients that need to be cared for, floors that need to be washed, meals that need to be prepared and delivered—work doesn’t necessarily stand still long enough to make sure that you get to everyone with the “right stuff.”

So, the question then becomes (as we move into the next phase of whatever it is we’re in—I’m not convinced that we will have the luxury of a “post-COVID” existence), how are you managing the onboarding process?

Are you relying more on computer-based learning to deliver the safety “message”? Are you doing more department-level education visits? How are you validating that what you are doing is effective—are you doing it during rounding and staff encounters?

I know there’s really no way to re-invent the wheel when it comes to the onboarding process (at least none that I’ve seen or heard of), but maybe there are some creative solutions out there in the studio audience that you wouldn’t mind sharing. If anyone chooses to reach out (again, will work nicely), I’ll collate and share with the blogosphere (with attribution, if you like, or with complete anonymity if that be your preference).

From a compliance perspective, I think the efficacy of the education processes is going to be a fair focus during regulatory surveys; they will (as they always have) try to pick on those most likely to fail subjects, so we need to keep folks sharp and ready.

Turns out the scope was not quite as brief as I might otherwise have thought…go figure!

About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at