Published Date: February 13, 2018
Staff orientation in an ASC is more than just a requirement of state and accreditation surveyors. It is vital to delivering quality care, promoting safe practices, encouraging teamwork and securing buy-in of an ASC's mission and culture. Missteps during the orientation process can jeopardize safety, compliance, the ability of a staff member to effectively fill a position and the desire for the new employee to remain with the ASC.
Ann Geier, MS, RN, CNOR, CASC, chief nursing officer for Surgical Information Systems, shares six dos and don'ts ASCs should know to help ensure they provide an effective orientation process.
Don't rush. ASCs often run lean to save money and maintain efficiency. When a new hire joins an ASC, there can be a tendency to put this employee to work as fast as possible, especially if staff feel shorthanded and the new employee feels comfortable doing so.
"I personally experienced an orientation process that was essentially just two days long," Geier says. "One day was spent reviewing the policy and procedure manual, and one day I shadowed another RN. Then I started providing patient care. Those two days of orientation were not enough for me to fully understand all the ASC's critical care processes, which created a liability risk for the center."
Don't break up the process. In another experience, Geier recalls receiving only part of the orientation process before she was assigned to work in the OR.
"The plan was to complete the rest of my orientation later," she says. "But it's difficult to get back on track with orientation once you have started serving in a role. Oftentimes, in this scenario, the second part of the orientation is rushed so the employee can get to work."
Do include credentialed providers. All staff, including physicians and CRNAs, should receive a comprehensive orientation. "Credentialed providers need to learn about the ASC's infection control plan, fire safety plan and evacuation plan, for example," Geier says. "Just because they are technically not considered employees does not mean they are exempt from orientation."
Do assign responsibilities. Everyone participating in the orientation should understand what they are expected to do to ensure proper completion of the process.
"You will want to define the supervisor's role and, for clinical staff, a preceptor's role," Geier says. "You will also, and this may come as a surprise to some ASCs, want to define the new employee's role in orientation. They are not an innocent bystander in this process. Their responsibilities should include maintaining their orientation checklist, informing their supervisor and preceptor of needs, asking questions and providing feedback. They should also speak up and remind their supervisor and preceptor of any important matters not covered during orientation that should be addressed before they 'fly solo.'"
Don't neglect paperwork. Orientation is comprised of a great deal of teaching and training, which can make it easy to overlook critical paperwork. This can include documentation for payroll, bloodborne risk classification, the ASC's mission and the employee handbook.
"Make sure your new employee completes the paperwork required by your accreditation organization and state department of health, and that copies of these signed documents are kept in the employee's file," Geier says. "Surveyors will usually detect when required documentation is missing."
Do allocate ample time for the facility tour. Even if your new hire has experience working in hospitals or other ASCs, this does not mean you should expect the employee to figure out the layout of your facility on their own.
"Setting aside plenty of time to provide a tour of your ASC is critical for several reasons," Geier says. "You need to identify all of the fire exits and extinguishers, medical gas shut-off valves, location of personal protective equipment and other important safety features. If your building has access and entry codes, you will want to review them. You also want to make sure you don't rush employee introductions. Even short conversations with coworkers can help a new employee feel more welcome and comfortable in their position."
Foundation for Success
Successful ASCs are busy. And that's good. After all, surgery centers are a volume-driven business. They're also a business that succeeds when the needs of its consumers are placed first. A comprehensive orientation process that doesn't cut corners will help ASCs achieve both objectives, Geier says.
"When you understand the needs of a new employee and make sure they are met, you are setting this individual up to be a productive member of your team who will support your ASC's mission and priorities," she says. "Take the time to develop an orientation process that covers all the bases and everyone physicians, staff and patients will reap the rewards."
Help orient your staff and ensure they are successful with AORN’s members-only tools and resources:
- Guideline Essentials- videos, audit tools, and more to help you and your team implement AORN’s evidence-based guidelines with ease
- Over 200 free CNE contact hours- webinars, tool kits, and more including Injection Safety: What Every Nurse Working in an ASC Needs to Know webinar, worth 1.0 CNE contact hour.
- Ambulatory Surgery Specialty Assembly- network and resource share with other ASC nurses
Not a member? Join AORN today!