One of the biggest challenges for allied health employers right now is finding senior allied health staff. This is not a new problem, but the current workforce shortages seem to be exacerbating it.

More senior staff bring experience, they are able to get up to speed quickly, and they are in a position to be able to support and mentor more junior staff. COVID-19 meant that many of our current cohort of new graduates (and some subsequent cohorts) have had limited access to clinical placement opportunities, so are hitting the workforce with less workplace readiness than normal, and a greater need for support.

If you have employed staff from overseas or perhaps someone who has worked in a very different context or setting to yours, you will also need to consider other aspects of onboarding such as understanding new systems, structures, processes, cultural and social norms—both within the workplace and possibly within a wider work or local community.

The lack of senior staff and the high support needs of more junior staff is a perfect storm at a time of enormous unmet workforce demand in the allied health professions. One way to support new staff to get up to speed faster in your organisation is to prepare a strong onboarding program.

Onboarding is not just for new graduates or less experienced staff, however if you prepare your onboarding program with these staff in mind, it will be easy to adapt your program for other (perhaps more experienced) staff who join your organisation.

For some inspiration from the world’s top organisations, take a look at how these onboarding programs are set up. Examples include Twitter’s “Yes to Desk” onboarding program, the Buffer “Three Buddy Experience”, as well as tips from LinkedIn, Google, Eventbrite and others.

Key themes across each of the programs are first that they all have a clearly structured program; they include an advance onboarding program that starts from the point of recruitment and introduces the new employee to important aspects of the organisational culture and systems; a big welcome (balloons, wine, handwritten notes); strong technical onboarding, which gets the new recruit up to speed with the technical aspects of their job, and has clear productivity goals (eg Facebook has new recruits working on their first project within 45 minutes of starting in the job!); a strong focus on and introduction to the culture of the organisation; creating connections—from breakfast with the CEO or executive team to ensuring new staff have access to a buddy or mentor—or team of mentors.

These examples are from billion dollar companies, but they have invested the time and resources to attract and retain the brightest and best staff to work in their organisations, and they also invest in those staff in a way that will optimise their productivity with their organisation.

The following onboarding guidelines have been drawn from a range of different sources and suggest a suite of onboarding activities you could consider from the time your new recruit signs their contract. Consider this more of a menu to choose from to suit your circumstances, rather than a prescriptive list.

1. Advance onboarding

The purpose of advance onboarding is to help your new staff member feel welcome. This will help to ease their transition into your workplace, but it can also reduce the amount of administrative time that could otherwise be handled prior to commencing the role.

Try to get the balance between welcome and overwhelm right. Don’t forget they have not started working for you yet.

Contact staff before they start work and get all of their administrative issues sorted out. Provide them with resources to help them understand the work context and environment, and if they are moving location, provide some information about the local area and region. If your new employee has any specific interests or activities, you could even point them in the direction of relevant contacts or connections in your area (such as sporting, religious groups or specific hobbies).

Advance onboarding could be supported by online or social media resources that you collect and collate over time. For example, you might have a private Facebook or Linkedin page where you post resources that are relevant to your organisation and could support your new recruit. If you gradually develop this over time, it will save you having to pull together a bunch of resources every time you recruit someone.

Alternatively, if your company has a public social media presence, you could use that as a way to provide a number of the opportunities outlined above.

2. A big welcome

I still remember the first day of my first job as a podiatrist. I was told to arrive at work at 8am, which I dutifully did, having only moved to the region two days earlier. My first patient was already waiting for me at 8am —the first of 14 clients booked in to see that day. I was lucky. Students who had studied on bonded rural scholarships were sent to rural communities to run practices with no support and no experience. That was in the days before clinical governance.  Fortunately, that was 30 years ago, and things have changed somewhat… haven’t they?

A big welcome doesn’t need to be extravagant, but it does need to be well considered. Ensure that your employee knows where to come, that they have access to car parking, that someone will be at the office to greet them—and is expecting them.  The purpose of the big welcome is to ease the transition into your workplace, to demonstrate the culture of your organisation (serious or fun) and to demonstrate the culture of your organisation to your employee. Twitter employees have a bottle of wine and a company T-shirt waiting for them when they start work, DigitalOcean puts a balloon on new employee’s desks.

Consider the supports your new recruit will need to help them get started, the people they will need to know and make it as easy as possible for them to feel welcome, comfortable and familiar with their new environment.

3. Cultural onboarding

Culture is ‘the way we do things around here’ and sets the tone for your organisation, the way you work together as a team and also the image you portray to your clients or customers.

The cultural onboarding will have started, informally at least, from the first point of contact your employee had with your organisation.

It will come from your branding, your website or social media profile, your advertisement (if you advertised for the role), the time taken to respond to your employee’s application and the way it was dealt with (eg a 3 month, highly bureaucratic and impersonal response, or a rapid and personal response), your own response to the employee and, of course, your big welcome.

For a large organisation, cultural onboarding may be directed centrally by your HR department and include information about the organisational values, strategic plan, organisational structure and board membership (if applicable). For a smaller organisation, cultural onboarding might involve meetings with key staff and / or a set of processes and procedures about they way the organisation functions.

If you have employed staff from overseas, cultural onboarding will need to be tailored to help them understand more than just the organisational culture, but also the wider community and health system processes and expectations. This can take some time.

4. Technical onboarding

Technical onboarding refers to anything your staff member needs to know in order to do their job to the best of their ability.

Individual allied health practices and organisations have their own specific, tailored systems, in-house workflows, technologies and tools. Some induction time will need to be put aside so that your new employee can become familiar with the technologies, processes and systems in place at your practice or organisation. If your employee needs access to a computer, make sure that is set up and accessible ready for their start.

Technical onboarding should include information about important partner organisations, access to funding sources if you access individual funding (such as Department of Veterans’ Affairs or the National Disability Scheme), structures or templates for report writing, processes of record keeping, triage, referral partners, and even details about using and driving the company car (if relevant).

If there are processes that all staff have to adhere to on a regular basis, some of the technical onboarding could be prepared as a series of workplace procedures.

5. Setting expectations

Giving your new recruit a full clinical load on their first day of work is probably not a reasonable expectation these days. However, having a staff member who is not contributing to your team and your organisation in a productive way in a reasonable time is also something you want to avoid.

Different types of practice and context will have their own requirements for getting staff up to speed, however it is important that you set clear expectations around what you expect your staff to achieve and by what stage, and that you communicate this clearly with your staff member and provide the appropriate level of support to enable their activity. This might include the number and acuity of clients you would like them to see within a set period of time; achieving specific learning (such as report writing or triage); gradually altering the length of time they spend delivering services; or completion of quality improvement projects or processes. Ensure that you create sufficient variety of work – whatever it is – to keep your employee interested and engaged.

6. Support structures

Provide clear lines of support to enable your staff to achieve the expectations you have set for them, and plenty of opportunities to learn. Consider making a mentor or buddy system part of your onboarding process. This may not always be practical or possible, depending on the type of organisation or allied health practice.

Having a mentor during onboarding gives your new employee access to someone who can provide guidance but is not in a direct position of authority or acting in an official capacity.

The support structures includes a clear understanding of line management and supervision structures, access to continuing professional development and training, and staff rotations (if applicable). If you can’t provide support in-house, there are a range of online mentorship and supervision options that may augment local structures.

7. Follow-up

Onboarding doesn’t just start and stop the day your new recruit arrives at work. Onboarding is a key component of your employee lifecycle which will then transition into the development phase of your staff member. Program regular times to check in with your new staff member. Create opportunities for them to ask questions, provide feedback or clarification. Be clear about your expectations of your new staff member and touch base regularly to ensure that you’re providing the appropriate support for them to meet those expectations, or to understand what might be standing in the way of those.

Review your onboarding processes and modify them according to what does and does not work and ensure they remain current in terms of any changes to your work practices.

Conclusion

There is no single right approach to onboarding, however there are a range of ‘ingredients’ that you can tailor to produce the most effective onboarding process for your organisation. Onboarding takes some investment to develop and sustain, but if it increases your staff satisfaction, enhances and reinforces your organisational culture, improves the quality of your patient experience and reduces staff turnover, then you will reap large returns on your onboarding investment.

For rural and regional practitioners, Attract, Connect, Stay is a detailed approach to getting and retaining staff.

We would love to hear your experiences and ideas of onboarding, or even just share your experience of your first day at work (good, bad or indifferent) in the comments below.