Individualizing the Orientation Process for Newly Hired CRNAs in a Large Academic Medical Center

Abstract

Purpose: The purpose of this scholarly project was to investigate whether an individualized clinical orientation would result in a shortened time to orient and integrate Certified Registered Nurse Anesthetists (CRNAs) into practice in a large academic medical center. By individualizing the orientation process, this project seeks to determine if this process change will lead to increased job satisfaction.

Methods: A new orientation process was developed and tailored to the needs of each newly hired CRNA. The new process provided tools to be used by new CRNAs and their supervisors throughout the initial clinical orientation period. New CRNAs hired to Mayo Clinic from September 2016 to February 2017 were oriented using the new process and tools. A survey was utilized to compare the satisfaction of the post-intervention group with a pre-intervention group of CRNAs hired from October 2011 to June 2016. The length of orientation for the pre- and post-intervention groups was also compared.

Results: Orientation time was decreased from 12 months in the pre-intervention group to an average of 5.25 months in the post-intervention group. This reduction included a decrease in the number of days spent in 1:1 orientation with a CRNA; from an average of 65 days in the pre-intervention group to an average of 32 days in the post-intervention group. The percentage of CRNAs who reported increased satisfaction or highly increased satisfaction with the orientation process was increased from 69% of the pre-intervention CRNAs to 78% for the post-intervention CRNAs.

Conclusion: This scholarly project showed an increase in satisfaction with the orientation process for CRNAs who received a tailored orientation versus a generic orientation, but was limited by a small sample size. The reduction in orientation time of over six months using the new process was clinically significant to the conducting institution. It allowed new CRNAs to be fully integrated into practice much sooner, resulting in a significant reduction in orientation costs.