As a Medicare surveyor, I am in many different facilities. One area I always find room for improvement is how new employees are trained and oriented.

It is important (and a requirement) to make sure a proper orientation process is documented and what it entails. The process must provide the date the employee was oriented and identify if that employee can perform in those areas. The employee must review, sign and initial, list their date of hire, list their title, and include the date they received the orientation.

The supervisor also must be named, along with their initials indicating the employee completed the review and any comments for each area reviewed. This orientation should be performed as soon after hire as possible but no later than 30 days.

Questions in this area always concern what should be reviewed. I have seen some strange items on checklists, including “How to tell when Dr. X is in a bad mood.” That is not a good checklist for orientation.

Below are the required items to review. There may be other items specific to your facility, but these are a minimum for the Centers for Medicare & Medicaid Services. These change often, so stay abreast of state and Medicare requirements.

  • General Orientation. Mission statement, goals and objectives, patient rights and responsibilities, abuse and neglect/reporting, advance directives, and facility tour.
  • General Department Polices. Employee handbook guidelines, quality improvement program, hand hygiene, code call response/emergency codes review/crash cart, reporting patient concerns/grievances, and vendor security.
  • Department Orientation. Tour of department, introduction to co-workers, conduct and courtesy, restrooms, time recording, lunch/break periods, phone use, and patient identifiers.
  • Training & Education. Age specific, fire safety (including exits and extinguishers locations), Health Insurance Portability and Accountability Act, corporate compliance, Occupational Safety and Health Administration, emergency preparedness, risk management (including incident reports), infection control, safety program, sharps injury prevention, radiation safety program, laser safety program, general safety and security, bioterrorism, and workplace violence.

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