Selected Podcast
Leading Disruptive Change: Transforming Your Onboarding Experience
Rachel Kelter shares how nurse leaders utilized disruptive innovation through challenging the status quo to facilitate a culture shift and onboarding practice changes for an entire healthcare system.
Featuring:
Rachel Kelter
Rachel Kelter is the manager of nursing education at Indiana University (IU) Health West Hospital where she has oversight for educational initiatives and outcomes. She received her BSN from Ball State University and MSN in nursing education from Benedictine University. She is also board certified in both nursing professional development and critical care. Rachel is a published author and has presented at several local and national conferences. Transcription:
Bill Klaproth: So how did nurse leaders facilitate a culture shift through disruptive and innovative onboarding practice changes? Well, let's find out with Rachel Kelter, the manager of nursing education at Indiana University Health, Indianapolis Suburban Region. This is Today in Nursing Leadership a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth. Rachel, thank you so much for your time. It's great to talk with you. So first off, why is the act of onboarding so important?
Rachel Kelter: Thank you so much for having me. I'm excited to talk with you today. The art of onboarding is so crucial and important because it really sets up our nurses on a positive journey for their entire nursing career. So from that very first day, a first impression that we give our nurses really sets them up for failure or success. And so it's so important that we are structured and have good processes in place and support to recognize our nurses, where they're at, and continue to help support and grow them for their long-term career in nursing.
Host: I love how you said that sets them up for a positive journey for their entire nursing career. Why did you feel you needed to redesign or design a brand-new onboarding experience?
Rachel: One of the things our organization was recognizing was that we were bringing on our new and experienced nurses and a very standardized one size fits all approach. And what we were hearing from our team members was, I am not being recognized as either a new nurse or experienced nurse with the life or nursing experiences I already have in place. And bringing that on board to this new organization. It really was a one size fits all and we were having a lot of classroom time and lectures. And we know from a professional development perspective, that's not the best way to onboard our new team members. That's not active learning, they're not really getting anything out of it. And so that this feedback we were hearing, not only from our new team members but from our preceptors or coaches, our leadership, really, we took all of this feedback and said, okay, where do we start to really quote, unquote, blow up orientation and how do we make this meaningful and fun and bringing joy back into onboarding? It felt very boring, it was the same thing over and over and over or what organization you are going to. So that really was the why behind it. We really wanted to make it fun and interactive and making sure that it was meaningful and again sets them up for success for when they continued on their pathway to their residency program or what we call transition to practice and then a lifelong career with us in our organization.
Host: Right. So how did you make it fun and meaningful? What were the changes you made?
Rachel: Some of the things we recognize is that socialization was really important to our new team members. And we really were keeping them to ourselves in this classroom just with each other. So we really started to incorporate opportunities for them to get out into the environment, to do fun tours within the hospital. So at our bigger facilities, at our academic health facility, we had them actually use iPad and it was like a big scavenger. hunt to find different locations and get to know the building cause it was so big., At the facility I supported, which was smaller, we still did more tours one-on-one base, but it was nice to get out and see the environment to see the people you're going to be working with. We set up what we titled immersion experiences. So how do we walk into the shoes of our colleagues that may be working in a different department that we have to admit to or from? And so it really put into perspective and the feedback we were getting was, this was really meaningful and fun to be able to see my colleagues in different departments. And I have more grace and understanding for when maybe they need to admit a patient very quickly, or they need to pause and maybe not a patient so quickly because they're overwhelmed with what's happening on the unit. So really it helped give some grace and compassion I would say for each other
Host: How long has this new onboarding experience been in place?
Rachel: The pilot facilities, which was one of mine. And then, like I said, our bigger facility it's been in place since about September 2018. But since we were the pilot, we really had the opportunity to create a structure and pilot what might work for a smaller facility versus a larger facility. But then when the entire organization rolled it out, they were kind of on their own timeframe. So that was really a different shift for our system and organization going from this rules-based, everyone has to change at this time period, following this prescriptive set of rules to really utilizing guiding principles. So here is a set of principles we want you to follow, but each facility has their own uniquenesses and community and culture. We want to make sure that we are a part of our larger culture, but then also honor those uniquenesses with each facility as well.
Host: Right. So what has been the results so far among the nurses that have been onboarded through this new experience?
Rachel: A lot of feedback we're receiving is that this has been the best experience they've had with onboarding. They come in really prepared to be bored and sit in a classroom, not get to know their team members. They want to get up to the unit a lot sooner. So we've really heard that a lot. Like, thank you for honoring the experiences I bring even as a nurse, because we have a lot of second-career nurses who aren't right out of college, or, you know, in their young twenties, they may be more experienced and have life experiences. So honoring that, or an experienced nurses who have worked at other facilities or organizations really individualizing that has been, I think the most important lesson learned we've had. And. It's been really meaningful for them to get to know each other and share knowledge among each other, and then also get to know their team a lot sooner too. And so with that, it really helps set them up for success for their unit-based orientation. And then so on with their residency program and after that.
Host: Yeah, that sounds really, really interesting. So then last question, Rachel, and thank you for your time. As we pull back for a wider view of this, how has this shift impacted the entire organization?
Rachel: Yeah. Great question. So this program to give a little bit of background, our system was going through a culture change, kind of like I mentioned before, where we are very rules-based. So anytime we rolled out any sort of professional development program, it was very one size fits all, everyone has to follow the same PowerPoint or set of instructions, curriculum, et cetera. And we couldn't really deviate from that. But what we were learning as a system is that we still want to align and systemness. There are other ways to keep that alignment, but also honor the uniqueness of each facility. So we were really transitioning into utilizing those guiding principles and so this program was really the first one to align that and have guiding principles. And since it was so successful were we all following the set of principles, but then created our own program at each facility that has really set the stage for subsequent programs here now two years later, where anything we've rolled out, it's really always following the guiding principles, lingo, and then how can we make that work for each of our facilities? While also sharing resources and information among each other too, which we've put a lot of structure and processes in place with shared governance and leadership to make sure we are doing those things too.
Host: It seems like this type of innovative onboarding could be used in all departments throughout the healthcare organization.
Rachel: Absolutely. And even beyond healthcare, I think that was the one thing that was an aha for me and a lesson learned, we looked at the literature, but outside of healthcare as well, we looked at how to do other industries onboard their new team members. And I think that really helped us think outside the box and really be innovative and creative with how we bring on our team members.
Host: Really fascinating and a really innovative and disruptive way to think about onboarding. Rachel, thank you so much for talking to us about this. We really appreciate it. Thanks again.
Rachel: Thank you so much. I've enjoyed this.
Host: That's Rachel Kelter and for more information, please visit AONL.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Today in Nursing Leadership. Thanks for listening.
Bill Klaproth: So how did nurse leaders facilitate a culture shift through disruptive and innovative onboarding practice changes? Well, let's find out with Rachel Kelter, the manager of nursing education at Indiana University Health, Indianapolis Suburban Region. This is Today in Nursing Leadership a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth. Rachel, thank you so much for your time. It's great to talk with you. So first off, why is the act of onboarding so important?
Rachel Kelter: Thank you so much for having me. I'm excited to talk with you today. The art of onboarding is so crucial and important because it really sets up our nurses on a positive journey for their entire nursing career. So from that very first day, a first impression that we give our nurses really sets them up for failure or success. And so it's so important that we are structured and have good processes in place and support to recognize our nurses, where they're at, and continue to help support and grow them for their long-term career in nursing.
Host: I love how you said that sets them up for a positive journey for their entire nursing career. Why did you feel you needed to redesign or design a brand-new onboarding experience?
Rachel: One of the things our organization was recognizing was that we were bringing on our new and experienced nurses and a very standardized one size fits all approach. And what we were hearing from our team members was, I am not being recognized as either a new nurse or experienced nurse with the life or nursing experiences I already have in place. And bringing that on board to this new organization. It really was a one size fits all and we were having a lot of classroom time and lectures. And we know from a professional development perspective, that's not the best way to onboard our new team members. That's not active learning, they're not really getting anything out of it. And so that this feedback we were hearing, not only from our new team members but from our preceptors or coaches, our leadership, really, we took all of this feedback and said, okay, where do we start to really quote, unquote, blow up orientation and how do we make this meaningful and fun and bringing joy back into onboarding? It felt very boring, it was the same thing over and over and over or what organization you are going to. So that really was the why behind it. We really wanted to make it fun and interactive and making sure that it was meaningful and again sets them up for success for when they continued on their pathway to their residency program or what we call transition to practice and then a lifelong career with us in our organization.
Host: Right. So how did you make it fun and meaningful? What were the changes you made?
Rachel: Some of the things we recognize is that socialization was really important to our new team members. And we really were keeping them to ourselves in this classroom just with each other. So we really started to incorporate opportunities for them to get out into the environment, to do fun tours within the hospital. So at our bigger facilities, at our academic health facility, we had them actually use iPad and it was like a big scavenger. hunt to find different locations and get to know the building cause it was so big., At the facility I supported, which was smaller, we still did more tours one-on-one base, but it was nice to get out and see the environment to see the people you're going to be working with. We set up what we titled immersion experiences. So how do we walk into the shoes of our colleagues that may be working in a different department that we have to admit to or from? And so it really put into perspective and the feedback we were getting was, this was really meaningful and fun to be able to see my colleagues in different departments. And I have more grace and understanding for when maybe they need to admit a patient very quickly, or they need to pause and maybe not a patient so quickly because they're overwhelmed with what's happening on the unit. So really it helped give some grace and compassion I would say for each other
Host: How long has this new onboarding experience been in place?
Rachel: The pilot facilities, which was one of mine. And then, like I said, our bigger facility it's been in place since about September 2018. But since we were the pilot, we really had the opportunity to create a structure and pilot what might work for a smaller facility versus a larger facility. But then when the entire organization rolled it out, they were kind of on their own timeframe. So that was really a different shift for our system and organization going from this rules-based, everyone has to change at this time period, following this prescriptive set of rules to really utilizing guiding principles. So here is a set of principles we want you to follow, but each facility has their own uniquenesses and community and culture. We want to make sure that we are a part of our larger culture, but then also honor those uniquenesses with each facility as well.
Host: Right. So what has been the results so far among the nurses that have been onboarded through this new experience?
Rachel: A lot of feedback we're receiving is that this has been the best experience they've had with onboarding. They come in really prepared to be bored and sit in a classroom, not get to know their team members. They want to get up to the unit a lot sooner. So we've really heard that a lot. Like, thank you for honoring the experiences I bring even as a nurse, because we have a lot of second-career nurses who aren't right out of college, or, you know, in their young twenties, they may be more experienced and have life experiences. So honoring that, or an experienced nurses who have worked at other facilities or organizations really individualizing that has been, I think the most important lesson learned we've had. And. It's been really meaningful for them to get to know each other and share knowledge among each other, and then also get to know their team a lot sooner too. And so with that, it really helps set them up for success for their unit-based orientation. And then so on with their residency program and after that.
Host: Yeah, that sounds really, really interesting. So then last question, Rachel, and thank you for your time. As we pull back for a wider view of this, how has this shift impacted the entire organization?
Rachel: Yeah. Great question. So this program to give a little bit of background, our system was going through a culture change, kind of like I mentioned before, where we are very rules-based. So anytime we rolled out any sort of professional development program, it was very one size fits all, everyone has to follow the same PowerPoint or set of instructions, curriculum, et cetera. And we couldn't really deviate from that. But what we were learning as a system is that we still want to align and systemness. There are other ways to keep that alignment, but also honor the uniqueness of each facility. So we were really transitioning into utilizing those guiding principles and so this program was really the first one to align that and have guiding principles. And since it was so successful were we all following the set of principles, but then created our own program at each facility that has really set the stage for subsequent programs here now two years later, where anything we've rolled out, it's really always following the guiding principles, lingo, and then how can we make that work for each of our facilities? While also sharing resources and information among each other too, which we've put a lot of structure and processes in place with shared governance and leadership to make sure we are doing those things too.
Host: It seems like this type of innovative onboarding could be used in all departments throughout the healthcare organization.
Rachel: Absolutely. And even beyond healthcare, I think that was the one thing that was an aha for me and a lesson learned, we looked at the literature, but outside of healthcare as well, we looked at how to do other industries onboard their new team members. And I think that really helped us think outside the box and really be innovative and creative with how we bring on our team members.
Host: Really fascinating and a really innovative and disruptive way to think about onboarding. Rachel, thank you so much for talking to us about this. We really appreciate it. Thanks again.
Rachel: Thank you so much. I've enjoyed this.
Host: That's Rachel Kelter and for more information, please visit AONL.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Today in Nursing Leadership. Thanks for listening.