What is it?

Onboarding is the process of bringing a new employee into an organization. The onboarding process involves administrative tasks like filling out forms and signing up for benefits, as well as activities to welcome the employee and introduce them to the organization’s culture. We can think about onboarding in three phases:

  • Preboarding:
    • Before day-one
    • Activities that take place before the first day on the job
  • Orientation:
    • First few weeks
    • Get employees settled in and acclimated
  • Integration:
    • Over the first year
    • Building comfort and confidence with the job and the culture

Just as in the recruiting stage, actions taken during onboarding have a significant impact on employees’ longevity in their role. A 2021 Gallup study found that employees who report “exceptional” onboarding experiences are 2.6 times as likely to feel high satisfaction in their jobs and as a result are far more likely to stay.

Best Practices in Onboarding

The onboarding process should be designed to set new employees up for success and help them become comfortable in their roles as quickly as possible.


  • As you plan the onboarding process, consider asking recent hires to share their experiences. Ask about the elements of onboarding that were most valuable to them and any recommendations they have for improvement.

  • As soon as possible after the job offer is accepted, email the employee welcoming them to the team. Share an itinerary for their first few days and any additional information they need to get off to a good start (parking details, meeting location, etc.). Let them know whom they should contact with questions.

  • Appoint an “onboarding buddy” — someone who is not the new employee’s manager and who can help them get acclimated, answer questions, and introduce them to others. Ask the onboarding buddy to send an introductory welcome email as well.

  • Send a welcome package to the new employee’s home. You might include small gifts such as a branded mug or T-shirt along with a card signed by other members of the team. Sending e-cards signed by the team works great for those working in remote environments.

  • Prepare a welcoming workspace for the employee. Ensure that any needed accommodations are available. Do what you can to ensure that all technology will be available as soon as the employee is ready to use it. If this is a concern, develop a backup plan so that the new employee has something to do while any technology hiccups are sorted out.

  • Have a learning plan for the first 30, 60, and 90 days ready to go on the first day. 


  • Plan the first few days carefully and share the plan with the new employee. Break learning into manageable chunks by incorporating time for individual work and reflection into the workday. Build in time for the new employee to meet with their onboarding buddy to touch base and ask questions.

  • Review job responsibilities in detail. Share information about the available resources that will help them be successful in their jobs.

  • Emphasize the big picture as well as the details.

Be sure the new employee has a clear understanding of the impact they have on the community, the organization, their colleagues, and patients.

  • Help the employee learn about the organization. Sharing organizational charts and introducing them to people on other teams can help deepen new employees’ understanding of the big picture and where they fit in.

  • During the first few days, assign a few small tasks. This will help the employee acclimate and begin to feel productive early on. Stay available for questions as they arise.

  • Check in frequently with the employee. During the first few weeks, a daily check-in is especially important. As the employee becomes acclimated, these meetings can be spaced further apart.

  • Encourage other staff to reach out to the new employee to welcome them to the team. Consider an “open house” style coffee chat or brown bag lunch. This provides an informal way for anyone in the organization to pop in and say hello.

  • Share information about workplace norms and other cultural elements. For example, do internal staff communicate most often in person? Via email or chat? Is there a strict expectation for meetings to start and end on time, or are these considered flexible?

  • If the new employee will be working remotely, it’s even more important to be especially vigilant about communicating and connecting. Set up time not just for talking about work, but also for helping them get to know you and others on a personal level. Consider scheduling virtual coffee hours or lunches with different staff members during the first few weeks.


  • As the new employee becomes more comfortable in their role, continue to find opportunities for them to get to know others outside their department. You might invite them to meetings where other departments will be represented, ask them to participate on a cross-functional project team, or encourage them to attend a social event that people from across the organization — or community — will attend.

  • Get them involved in their own development. Ask what knowledge, skills, or resources would help them be more effective in their role.

  • Identify at least one milestone worthy of celebration. You might schedule an informal gathering to recognize the new employee’s 6-month anniversary, learning a new procedure or process, or the successful achievement of a key goal.

  • See more tips related to Learning & Development and Employee Engagement in the next two sections of this guide.

Onboarding Tools

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National Rural Health Resource Center

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National Rural Health Resource Center

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Key Takeaways

  • Before their first day, connect with new employees to welcome them and help them know what they can expect during the orientation process.

  • Appoint an “onboarding buddy.”

  • Develop a detailed plan for the first few weeks on the job. Share this plan with the new employee.

  • Avoid information overload during the early days by interspersing learning with reflection and work time.

  • Check in frequently.

  • Help new employees get to know others personally as well as professionally.

Rural Health Care Onboarding in Action

To address high first-year turnover rates for new employees, Golden Valley Memorial Healthcare (GVMH) in Clinton, Missouri, instituted a robust and prescriptive process for onboarding new staff. The program used many of the best practices outlined here, starting at the point of employment acceptance and going through the first 90 days. Since program inception, first-year turnover at GVMH has dropped by 20 percent.


National Rural Health Resource Center

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