Training Staff in a Pediatric Practice

Hiring a new employee requires significant investment for any practice in terms of time, money, and energy. The practice needs to develop the skills and attitude in the new hire that will match and enhance the practice culture. The employee, current staff, and practice as a whole will benefit from the initial time and effort spent to affect a positive introductory period. A well-planned and thorough orientation program provides specific goals and defines the practice’s expectations of the new employee. Be sure to check with your state laws on appropriate training (eg, Occupational Safety and Health Administration). 

Orientation 

Create a customized orientation program for each job type. Each program should serve as a welcome to new employees and inform them of the practice’s mission and values. The orientation should be a formal and structured program that specifically outlines what the employee should know about the practice. The orientation should include: review of the practice’s history, mission and vision, review of rights and benefits, patient confidentiality policies and procedures, as well as compliance issues (eg, OSHA compliance plan, and hostile workplace issues). Click here for a Sample Orientation Checklist​. 

Meeting Staff 

Provide everyone in the practice an opportunity to meet the new employee in a less formal setting than a staff meeting. This can be done using an introductory breakfast or luncheon, or just a short meet and greet with snacks. If the practice does not use them already, consider having name tags to make it a little easier on the new employee their first day. 

Review the Employee Handbook 

Review the employee handbook, highlighting key areas related to policies, procedures, benefits and other daily issues for which standards have been set. Past experiences, positive and negative, can help inform the decision as to which areas of the handbook are most important to highlight. 
  
Direct the new employee to the employee handbook and practice policies and procedures. Allow solitary time for reading and review time daily within the first few days to weeks. Encourage questions about policies and why the practice does things in a prescribed way.  

Observation Time 

Schedule observation times varying from 1 to 3 hours with employees in other positions to expose the new staff member to all jobs. This encourages one-on-one conversation and may provide insight into the job duties in which this staff member is best suited to be cross-trained. 

Assign a Mentor 

Assign a mentor to the new employee for the introductory period. This staff person should not be a direct supervisor but should instead be someone who functions as a leader in the practice (regardless of actual job title). The mentor should have experience and judgment that has proved trustworthy, and have enough knowledge of the employee’s new area of work to support them effectively. Provide the mentor with a defined orientation plan to guide the mentor and employee through the introductory period. The mentor should be allowed space to continue doing their own job effectively. The new employee should be encouraged to develop relationships with other coworkers as well as their supervisor. 
  
During the introductory period, the practice manager/administrator should visit with the new employee and mentor separately on a regular basis. This could be weekly or every 2 weeks, depending on the individual. 

General Guidance for the Orientation Period 

An employee who has a good understanding of the work environment and is comfortable with the expectations of the practice is far more likely to be productive and effective. Particularly in the start of a new work relationship, the fear of failure is common. A thorough and well-developed orientation schedule can alleviate fears and anxieties during the introductory period and encourage better performance. 
  
Orientation takes time, of which most practice staff have precious little to spare. Using a variety of media tools such as online or external training resources (eg, software company), can provide some relief in regards to time commitment on current staff while still providing the new employee the orientation needed to ensure a successful transition into the practice setting. Be creative and open to new ways of conducting the orientation, and modify the format as needed. 
  
Each orientation session is a good opportunity to obtain feedback from a new employee who has a fresh perspective. Remember to ask the new employee how they feel the process is going and what might help improve the quality of the orientation. This is an opportune time to begin modeling the style of communication that is expected, which can allow for a trusting, open rapport between the new employee and all colleagues that will continue to grow during their time at the practice. Extra time spent during this initial period is an investment that will hopefully pay off in a stronger new employee and a more effective pediatric practice team. 

When the practice experiences a change in workflow or when there are changes in policy or regulation, it is best to train staff in a timely manner to ensure that guidelines are properly met. This can include: 

• Technologies/equipment (eg EHR system, medical instruments) 
• Compliance and certifications (coding, OSHA, HIPAA) 
• Medicaid and Medicare issues 

There are a variety of methods for creating training and educational plans for staff. Select a process that works best based on the needs of the practice. Some options include: 

• Train-the-Trainer  – This model enables a designated staff member to receive formal training on a specific topic. This staff member then trains the remaining office staff. This can ensure that staff receive timely training to complete tasks according to revised policies and procedures. 
• External Trainer  – This approach typically is used when practices hire an outside expert or consultant to train staff on-site. This can be beneficial for technology-based trainings such as EHR systems or new healthcare instruments. 
• Off-Site Training – This method involves sending staff to trainings that are provided through local hospitals, medical societies, organizations, etc. 

Throughout a staff’s tenure with a practice, there will likely come a time when staff may assume new responsibilities. 
 
Coaching staff who have been identified for new roles is important to that individual’s success. This process allows staff to fully understand the expectations and responsibilities of the new roles, ultimately increasing their aptitude and performance. It is also imperative to acknowledge, track, and document employee training records as they can assist in writing future performance reviews and appraisals. 
 
Ultimately, at any level of employment, staff training and education should be an on-going process. A commitment to training can help increase teamwork, employee morale, communication and practice capability. 

Additional New Role/Responsibilities Resources: 

• TeamSTEPPS for Office-Based Care Training Videos, Agency for Healthcare Research and Quality, November 2018 
• 10-step process for developing training courses​