Improving Manager Onboarding to Drive Organizational Performance in Primary Care - Evidence Based Pr

Although managers are the keystone to the success of high functioning teams that drive organizational performance, they are often given half- baked onboarding due to competing priorities, time constraint, lack of mentorship and the associated cost.

Objective: The purpose of this project is to Implement a manager onboarding program in the primary care setting to increase the intent to stay,  knowledge and confidence leading teams to achieve the quadruple aim of Quality & Safety, Service, Affordability and Work-life balance.   

An onboarding plan for managers in Primary Care (PC) at this medium health system will improve their efficiency and equip them with the skills and confidence to effectively create and lead highly engaged & functioning teams.

Methods: A literature search was done on key databases. Eight articles were chosen and reviewed for evidence in relation to the project question- How does a structured onboarding of managers in their specific service line affect their knowledge and confidence to lead high functioning teams to achieve patient quality and safety?

In addition to the literature review, interviews were conducted of recently hired managers, director level leaders, Human Resources (HR) representative, Chief Nursing Officer (CNO) and leaders  from other organizations to collect and assess current and any best practices across the organization.

Out of eight articles reviewed, three make strong connection between onboarding, engagement, role satisfaction and retention. Three of those eight elevate the importance of developing an onboarding plan that is individualized and tailored to the role and goals. Four out eight explicitly concluded that a good onboarding practice must have a mentoring component and one article made a bold association of onboarding and improved patient outcomes.

Manager Onboarding in Primary Care

Brief Description

Ambulatory care curriculums are not well developed in nursing programs, so there is already a gap in nursing leadership in ambulatory care settings like primary care (PC).
There is literature evidence that proper onboarding of managers improves knowledge and confidence to lead teams, retention, and job satisfaction, as well as engagement, better patient care outcomes, higher productivity, and cost-saving. Conversely, lack of adequate onboarding leads to a lack of role clarity, poor engagement, high turnover rates, which can be costly to the organization.

My evidence-based practice (EBP) project will address the gap in my organization’s onboarding practices for managers in Primary Care. These managers include the Clinical Operations Manager (COM) and Medical Center Manager (MCM).

Currently, the organization doesn’t have an onboarding plan for managers except for a four-page checklist that is neither structured nor comprehensive. Managers are the keystone to the success of high functioning teams that drive organizational performance and yet, they are often given half- baked onboarding due to competing priorities, time constraint, lack of mentorship and the associated cost. As a result, there is a high manager turnover leaving unstable and disengaged front line staff and ultimately inconsistences in overall organizational performance.

PC leaders are tasked to achieve the quadruple aim of Quality & Safety, Service, Affordability and Work-life balance. We need to invest in an onboarding plan that will equip managers with the necessary skills to effectively create and lead high functioning and engaged teams. Front-line teams ultimately drive improved patient outcomes and overall organizational performance.

 Project Question

 How does a structured onboarding of managers in their specific service line affect their knowledge and confidence to lead patient quality and safety?