Can nursing orientation costs be managed? Should they be?

Orientation for new-hire RNs in hospitals is costly. In an article in the journal of nursing economics, the average (16 weeks) unit-based orientation cost was estimated at $41, 624 – and this was published back in 2007.

Let’s update this a little using more recent salary related costs; according to KPMG’s 2011 U.S. Hospital Nursing Labor Costs Study, the total cost of a full-time RN averages $98,000 per year (or $1885 per week).  Thus, the average cost for the preceptee’s time would be a little over $30,000 (16 weeks at $1885 per week).  Adding another $30,000 for staffing the vacancy during the orientation the total cost reaches over $60,000.  So far, we haven’t included all of the cost factors yet. 

Factors impacting the costs include but are not limited to: 

  • Hospital policy on staffing the preceptor/preceptee patient load
  • Length and design of the classroom and unit-based orientation 
  • Salary for those involved in nursing orientation including the preceptor(s), preceptee, unit educator, orientation classroom trainer, orientation program manager, etc.
  • Salary for those brought in to cover the patient load for the vacant position while the orientation is underway
  • Payroll related costs such as social security and 401K contributions, unemployment and workers compensation insurance, health care and other benefits 
  • Orientation program support costs such as materials, maintaining the program due to equipment upgrades, regulatory or accreditation changes, and other changes in hospital policies and systems.
  •  The way the hospital allocates other general hospital overhead costs to the program.

 Can this cost be managed? 

Some of these costs could be managed by nursing management. For example, the policy on staffing load assigned to the preceptor(s) and preceptee determines a significant part of the salary costs.  The length and design of both the classroom and unit-based orientation components is also largely under the control of the nursing organization. Other cost factors cannot be managed directly such as the hospital benefits program.

How can cost be managed?

A classic process management approach would be to measure and take actions to improve:

  • Cycle time (length of the preceptorship),
  • Efficiency (cost of the resources used per preceptorship),
  • Effectiveness (outcome of the preceptorship); and some would add
  • Adaptability (variability of the other measures under different loads such having one new hire in orientation on a unit verses having three new hires in orientation).

 Can the high cost of nursing orientation be managed? Yes.  Should it be done? Yes; but only if you are able to lower costs while maintaining or improving effectiveness at the same time.  It can and has been accomplished for many other processes in a wide variety of organizations.  

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The Preceptorship Support Platform Explained

The Preceptorship Support Platform is an online tool built to support nursing orientation programs by providing a paperless solution for documentation and process management. Each feature of the program has a specific purpose, and the platform was built in collaboration with nurses to incorporate best practices (like those laid out in this article from American Nurse Today) because we wanted to make nurses’ lives easier.

What are the features?

Checklists

Hospitals can add their custom clinical and policy checklists to the platform so new hires and their preceptors can keep track of their progress online. Because this tool is completely customizable, hospitals can add documents, images, or links to other sources in their unit and hospital-wide checklists.

Patient Log

Like with the checklist feature, orientees can record their patient experiences to be approved by their preceptors online. This section also includes a visual tool that allows both orientees and preceptors to see what diagnoses and skills preceptees have had a chance to observe or assist with.

Capture

With this tool, preceptees can see what they need experience with and precepetors and coordinators can make sure that new hires are on track with their orientation.

Meetings

While preceptors and preceptees should be meeting regularly to set goals and give feedback, we know how difficult this can be to arrange and keep up with. Having structured meeting templates with built-in goal setting and feedback can help nurses find time to have these essential meetings and make sure that they are effective. Hospitals can customize the structure and frequency of these meetings to fit their program.

Journal

Self-care is an important, but often overlooked, piece of a successful preceptorship. Keeping a journal is one way that new nurses can reflect on what they have learned, the challenges they’ve faced, and the successes they’ve had. Including journaling in a program that helps to manage the rest of their orientation will encourage them to engage in reflective learning activities in addition to their regular clinical training.

Well-being Tracker

As a part of the journal feature, preceptees are asked a series of questions meant to assess their overall well-being. Preceptees can see how their answers vary over time so they will know when to ask for help, and preceptors and managers can see an overall well-being score so they can intervene if someone is struggling.

wellbeing
Preceptee View

Shared Notes

Because some new hires have multiple preceptees, coordinators, and managers involved in their orientations, the shared notes section is available to make it easier for everyone to stay in the loop. The ability to access these notes, checklists, and other documentation is one of the main benefits of transitioning to an online program that saves time and paper.

Overall…

  • New hires are responsible for driving their progress. They can work through the checklists at their own pace, and they are responsible for submitting completed lists and patient logs to their preceptors.
  • There is built in feedback for preceptees. Studies show that consistent feedback is necessary for new nurses to succeed, so the platform is built so preceptors have the opportunity to submit feedback as preceptees work through their checklists and log patient experiences, in addition to discussing performance during meetings.
  • All of the documentation, including preceptors signing off on each skill or checklist, is automatically recorded, so orientation coordinators can easy compile reports.
We’d love to talk with you about how the Preceptorship Support Platform can benefit you.
Schedule a live demo.