How Good Onboarding in Healthcare Leads to Better Retention

Across the healthcare industry, retention is top of mind for employers. Turnover in healthcare has dropped from 20% in 2023 to 18% in 2024. Even with this decrease, frontline engagement—in roles such as nursing, security, and service—remains an issue and a top-of-mind conversation in healthcare.

Some of these engagement issues are due to generational differences between Millennials and Gen Z employees and the older healthcare workforce, particularly in high-stress clinical environments. But retention itself is driven primarily by employee trust and initial experience at a company. One of the best ways to increase retention from the get-go is through your onboarding process.

Excellent onboarding is a key factor in building and retaining employees. Let’s take a look at some common onboarding mistakes and ways to boost healthcare employee retention using insights from Jessica Calzaretta, President of Insight Global Health.

Common onboarding Mistakes

In healthcare, where patient outcomes and safety are directly impacted by staff performance, the onboarding process is one of the most overlooked areas of employee engagement. First impressions form strong opinions. And the first few months in a role inform your employees’ mindset about you and your company. In fact, in 2021, only 12% of U.S. employees experienced a good onboarding process and said their company onboards well. And in 2024, 34% of candidates said their onboarding journey failed to meet their expectations.

A positive onboarding experience matters greatly to new hires and increases wellbeing and intent to remain in the job. We conducted a survey of more than 900 full-time employees, and 80% agreed that if their onboarding experience were better, they would stay longer in a job.

The biggest obstacle companies must face is creating a sense of belonging. “Unfortunately, not very many companies actually get this right,” Jessica says. But there are a few areas where small changes will go a long way regarding your employee retention.

Best Practices For Onboarding & Driving Retention

“Onboarding is such a simple concept,” Jessica shares. “I think most people would agree [that it] generally matters. But what we see is that it’s often overlooked and more of a check-the-box-type process for a lot of employers.”

So let’s reframe the onboarding process. On a surface level, onboarding looks like getting your employees up to speed with day-to-day tasks. But improving the employee experience actually begins during the interview process.

So how can you effectively use your onboarding program to improve healthcare employee retention rates? Here are a few ways we’ve identified to create connection and trust from the beginning of recruitment.

Positive Interview Experience

Retaining your employees doesn’t start after they accept the offer letter—it starts before. “A lot of the decision to remain with an employer really starts in the beginning,” observes Jessica. Without setting clear expectations during your recruitment process, candidates and future employees won’t have a good idea of who your company is, what you stand for, and how the company treats its employees. Employees who not only enjoy their interview experience but leave feeling understood are more likely to connect with you and your organization.

Excellent Communication

Without excellent communication before and after the offer letter is sent, employees will feel like they’re standing on shaky ground. Keeping them in the know creates trust from the beginning and sets expectations of how you operate as their leader. Avoid withholding information and delaying communication.

Clear Onboarding Timeline

“A misconception around onboarding is that it’s just that time period leading right up to when somebody joins an organization and maybe that first one to two weeks once they begin,” says Jessica. But onboarding is a far lengthier process than this.

She goes on: “Onboarding, from our perspective, is: What does the journey look like for your new hires or employees in their first twelve months of assignment?” By considering the first six to twelve months of your new employee’s tenure, you can better communicate both your expectations for the role and any potential growth plans moving forward.

Concrete Onboarding Process

Insight Global has found that individuals who do not go through a formalized onboarding process back out of their jobs at an 80% rate. In healthcare, this can lead to understaffed units, delayed patient care, and increased burnout for remaining staff. Those who go through a full and engaged onboarding process bring that statistic down a staggering amount.

“It’s a pretty negative experience when people don’t show up with our involvement,” Jessica says. “With our customized solutions, we were actually able to deliver less than 8% back-outs” to a healthcare client. Never underestimate the importance of customizing and creating a process that makes your candidates feel seen and appreciated on top of feeling accurately informed.

Culture & Values

When onboarding new employees, it’s important to connect the expectations of the role with the results your organization aims for. It’s also important to identify what matters to your company through your culture and values. Employees want to feel connected to their work. Beyond the job description, values are what connect your employees to your why.

“Every organization has a different set of values, different culture, and maybe even a different purpose,” says Jessica. She affirms that the more you can do to connect your values, culture, and purpose with the results your organization is trying to achieve—from revenue targets to patient outcomes—allows you to set your employees up for success.

Communicating who you are and how your employees can engage in your mission through their work— whether it’s improving community health, advancing medical research, or providing compassionate patient care—creates purpose and a reason to stay. This connection inspires belonging, productivity, and achievement, creating a more positive working experience for your hires.

WATCH NEXT: Reshaping Your Onboarding Process To Make New Hires Successful

Intention Leads to Retention

Healthcare employee retention isn’t rocket science. When it comes to employee experience, Jessica says, “It’s all about execution and intention.” Technology and innovation can speed processes along or create temporary excitement at the beginning of the hiring process. But ultimately, it’s the genuine and authentic human connection that matters most.

Prospective employees look for leaders who possess intention. When you put your people first, they tend to feel aligned with your mission.

At Insight Global, we’re all about building stronger teams that last. We’re fully equipped to not only help you staff and onboard your employees but also to support you beyond your staffing needs through our professional service offerings. If you’re worried about retaining your employees, we want to help you take the pressure off your frontline workers by providing insights and administrative help so you can focus on what matters: your healthcare employees’ retention and experience.