Turning a choice interviewee into a top-performing employee begins as soon as the hire is made. You hired her because of her skills, knowledge and experience. Now it's your job to help her put those to use in your office. In this ar-ticle, I'll provide guidance on orienting new ad-ministrative employees to the practice.

A Strong Start
Once you've hired a candidate and agreed upon a start date, you need to begin planning her training and orientation. Schedule training over several weeks, and make sure to arrange for outside training (e.g. special training on your EMR software). Decide who will be responsible for introducing the new employee to certain tasks, and make sure to give the other "teachers" plenty of advance notice. In this stage, you, the trainer, assume the majority of the responsibility for the training.

If your practice doesn't have a formal introduction and evaluation process for administrative employees, now might be the time to create one. If you need some guidance, books such as Creative New Employee Orientation and New Employee Orientation Training are available from the Society for Human Resource Management (shrm.org), as is the Medical Practice Performance Management Manual: How to Evaluate Employees, 2nd Edition from the Medical Group Management Association (mgma.com).

Define Expectations
From the first day, set the tone for the working relationship. Start by establishing a regular meeting time that is carved in stone. By honoring this regular meeting, you show the employee that you consider your time together a priority. The most successful practices are those where the medical staff and the administrative staff have time to discuss issues and keep each other up to date.

Review the job description with the new em-ployee and outline your expectations for the introductory period, for six months, for the year, etc. For example, if you expect your new office manager to be processing the payables within three months, specify this. If you expect that after three months of employment, the new receptionist should be able to accurately enter demographic information and post charges, clearly communicate this to the employee. Establishing specific time frames and quantifiable objectives enables the new employee to mark progress and evaluate her own performance. The responsibility for training is shifting to the employee.

The Office Culture
View orientation as a time when the employee is exposed to the culture of the practice. When training a new receptionist, you should address in detail your practice's policies on customer service, integrity (billing compliance), confidentiality (the Health Insurance Portability and Accountability Act) and even the dress code. While you will have covered these topics in general in the interview, this is the time to be practice-specific. For example, in the interview you should have screened your candidates for an understanding and appreciation of confidentiality. Use the orientation as an opportunity to introduce your HIPAA policies.
Ophthalmology Skills
Part of the orientation should include a job-appropriate introduction to the field of ophthalmology. The American Academy of Ophthalmology offers several videotapes aimed at ophthalmic medical assistants that will also prove useful for orienting administrative staff. New hires should be required to watch them. Let new employees observe others administering diagnostic procedures such as visual fields, Heidelberg Retina Tomographs and autorefraction. If she is willing, ask the new hire to act as a patient and perform the tests on her. This firsthand experience will enable the employee to allay patients' fears about testing. Similarly, familiarization with ophthalmic testing renders the billing staff member more knowledgeable about the procedures for which she is submitting claims.

Measure by Measure
New jobs can be overwhelming. Don't drown the employee with too much information too soon. In your regular meetings, in addition to providing your feedback, be sure to ask the new employee how she thinks the orientation is going. This helps both the trainer and the new employee focus on what has been mastered and what they still need to cover.

Adult learners benefit when the teaching methods are varied: demonstration, observation, use of videos, etc. Structure the orientation to allow the new employee to observe as other staff perform their jobs. New office managers will want to spend time at every station; front desk staff should observe back-end billing; billers should observe how the demographic and billing information is collected at the front end. This helps integrate the new employee into the practice and also shows her "the big picture."

Technology Training
Telephones. As office technology has become more complex, so has the training to use it. An introduction to the computer system and ophthalmic diagnostic equipment often happens first because they seem the most relevant, but don't short-change the new hire in the area of telephone training. Lost or dropped calls mean lost revenue. Every employee should be trained in phone protocols. Include:
 • How you want the phones answered;
 • Which lines "roll over" (what happens when the line goes unanswered);
 • Where calls are routed on the auto-attendant system;
 • How to handle emergencies.

General billing. Before starting on the practice-management system, spend some time reviewing general billing concepts and carrier rules. Be sure to have "cheat sheets" prepared so that the new employee knows such things as which procedures need to be precertified and when patients need a referral.

Practice-management software. Training on the practice-management system takes time and should be carefully or-chestrated. All too often, the receptionist whose performance on the software is marginal is entrusted with the responsibility of training the new employee. This is a recipe for disaster. The better choice is to schedule training for the new receptionist with a staff member who is experienced, knowledgeable and a good trainer. Find out if your software vendor has training programs available—a worthwhile expense.

The new employee will learn the system properly and may even be astute enough to discover reports or tools within the software's capabilities that are going unused.

Training on the practice-management system should take place away from the front desk. All too often I see new receptionists being trained at the front desk while patients are waiting in line to check out. This is frustrating for patients, distracting to the trainer and stressful to the student.

When I hear managers say they don't have time to train new employees in a formal way because they are so short-handed, I believe they are being shortsighted. I try to impress upon my clients the truth of the statement that if they take the time in the beginning to properly orient the employee, they will recoup the time a thousandfold. Plus, a busy manager who trains someone right the first time will save the effort of retraining the same person, or even starting the hiring process over again when a disillusioned new hire quickly leaves the practice.

Ms. Cutler has 20 years of practice-management expertise. She may be reached at (215) 568-3579 or lcutl3579@aol.com.