Albany Medical Center

Patient Access: Learning Partner Orientation October 2009 Table of Contents:

I. What is a Learning Partner A. Your role to educate to the Organizational and Department structure (orientation manual)

II. Role and Responsibility of the Learning Partner A. As a Role Model B. As a Socializer C. As an Educator a. Generational Differences in Learning Expectations b. Adult Learning Principles c. Learning Styles

III. ‘Tools’ for the Learning Partner A. Job Description review B. Department Orientation Program C. Unit Orientation Program a. Unit based training program b. Introduction to the Competency Based Orientation Tool (CBOT) c. How is the CBOT incorporated into the Learning Environment d. Orientee and Learning Partner Assessments IV. Manager – Learning Partner and Orientee Review A. The Learning Partner’s role in the review process B. What to expect in the review process a. Escalation of concerns

What Is A Learning Partner…..?

The Patient Access Learning Partner plays an integral part of the new team member’s onboarding (orientation) process.

You remember when you were the newest member of the team ~ how awkward and sometimes scared, as you entered your new job and your new unit for the first time.

You, as the Learning Partner, assist the new team member to acclimate, to ‘fit in’, to feel that they are a part of the team.

Not just anyone can be an effective Learning Partner. You have demonstrated the traits, the attributes it takes to be successful. A positive role model A winning attitude An ability to promote an environment of teamwork Resourceful – providing guidance to staff and utilizing training and policy and procedure manuals Concerted effort to achieve accuracy and productivity standards

Thank you for embracing this important role ~ a good Learning Partner makes all the difference to ensuring a successful orientation process!

Staff Orientation and Retention: Learning Partner Guide

Key Components of Department Orientation

1. Selection  The selection process for new staff members is based upon specific criteria which is designed to create a match for department needs in interpersonal relations, technical skills, critical thinking abilities  The selection of new staff members matches goals of the department with strengths of the individual  Selection practices involve members of the department

The orientation process really starts with the first meeting a Manager has with a potential employee during the interview since this is the time that initial expectations for job performance are discussed.

Wouldn’t it be great to have a refined and honed hiring process to such a precise science that it’s a rare occasion when a candidate doesn’t succeed? It is possible- but requires work and skill development. It is important to develop and use proven strategies in the hiring process to weed out poor candidates and get new hires off on the right foot.

High turnover of staff has a negative effect on a department’s morale and productivity. Retention of the new employee hired can be related, in part, to finding just the right individual in the first place. The selection process for new employees is one that the manager must pay particular attention to.

2. Key Role of the

Manager  There is a plan for managing and providing remediation for the new staff member who is not meeting expectations  The manager has a clear vision of their role as coach  The manager assures completion and filing of all orientation documentation tools

To all employees, the manager is a pivotal figure within the service area, and as such, a relationship with the manager must actively find ways to develop a positive and visible relationship with new employees. What better way to establish this relationship that active involvement in a new employees orientation process?

3. Learning Environment  The department pays attention to creating an environment conducive to learning for new staff members  There is a team approach to facilitating learning – all staff members contribute – *New staff are welcomed and encourage by all department staff *All staff members know and support the process orientation in their department  Work assignments in the department are adjusted to allow the learning partner and new staff member time to teach and learn in order to meet the goals and outcomes of orientation Do you remember what it felt like to be new in your job? Was it stressful? How did you manage learning in the stressful environment? Was it a patient environment that gave you the time and support to learn, develop new skills, and begin your socialization into a new career? Did you have the resources and tools you needed to do your job? Did you feel welcome?

All department staff members have a responsibility to create a supportive and welcoming atmosphere. The expectation is that staff will be accepting of the new employee’s current level of ability, knowledge, and skills throughout the orientation program. Each staff person can help to facilitate the assimilation of the new employee into the department. They need to know the orientation plan so they can support the process. They need to lend expertise to the learning partner and/or the new employee and assist the learning partner with learning activities if needed. The department staff need to acknowledge the additional workload the learning partner has due to the orientation process and demonstrate a willingness to adjust work assignments to allow the learning partner and new staff member time to teach and learn in order to meet the goals and outcomes of orientation. They need to help the new staff person to feel welcome.

4. Belonging  Staff are welcomed, socialized and included in department activities as well as formal and informal ways of doing work in the department  Managers plan to be involved in the staff person’s orientation: *meets with the new staff member a minimum of every 2 weeks *aware of the new staff members progress and issues *are visible and available to new staff member’ s individual *are approachable  The manager and staff demonstrate and communicate respect for the new employee

It is easy to focus only on the knowledge and skill components of orienting a new employee to the work setting since these aspects are crucial to success and independent function. Equally important, however, is the assimilation of the new employee into the existing work team. This aspect of orientation, to assist the Orientee to integrate socially as a team member, entails structuring the orientation plan to include methods to foster acceptance, respect, and welcoming into the work team. Failure to integrate a new employee into the department can often lead to an employee leaving the institution because they never felt as if they belonged.

Paying attention to developing and implementing concrete plans to integrate new employees into the work team will help to make them feel welcome. Learning that is facilitated in a positive environment within the department leads to early productivity as well as diminishing the potential of losing an employee because they never felt they became a part of the team.

5. Learning Partner  Selection criteria for learning partners are defined and used  A consistent learning partner is assigned to the new staff member to oversee and facilitate the orientation process  The learning partner is accountable for assessing and documenting progress toward learning outcomes on a regular and consistent basis

The roles of the Learning Partner are to educate, serve as a role model and socializer. The learning partner (or preceptor) is responsible for the oversight of the entire orientation process, including assessing, planning, implementing, and evaluating the orientee. The learning partner is a coach, an instructor, a guide and a mentor for the new employee. The learning partner must be proficient in the application of adult learning principles, problem solving and evaluation of performance.

The learning partner collaborates with the manager and orientee to develop an individualized plan. The learning partner and Orientee pair need to develop a meeting schedule (at least once per week) to evaluate progress in a formal manner and assure goals are being met. When the orientee is not meeting goals- the learning partner communicates findings to the manager and collaborates in the development of a remediation plan. Learning Partners must communicate a status report to the manager on a regular and routine basis.

The Learning Partner needs to assure the department has teaching and learning resources available and if not, this needs to be communicated. The Learning Partner must be knowledgeable of the competencies required of a new person at the end of orientation. The Learning Partner needs to be preaised and recognized for their contribution to the orientation process. The manager is responsible to assure these have been identified and documented in the competency based orientation tool.

6. Goal Orientation  The department orientation is organized in a competency based approach which includes: *Regular intervals to evaluate progress *Defined criteria are used to determine when orientation is completed *Competency based documentation tools are developed an used *The outcomes and goals of orientation are defined and evaluated regularly

How do you know when orientation is over? What is the desired product? A goal oriented orientation is one that is planned with specific outcomes so that you know when the end-point has been reached. Initiating Orientation At the beginning of orientation, each new employee is expected to complete a self- evaluation of their ability to perform the competencies of the job. The learning partner, along with other department support staff, reviews the self-evaluation for the purpose of evaluating the orientee’s learning needs and planning a goal oriented orientation to meet those needs.

During Orientation The department determines the frequency of regular evaluation intervals during the orientation process. The performance period depends on the length of the orientation and the needs of the orientee. The performance of the orientee is reviewed and documented on the Competency Based Orientation Tool (CBO Tool) by the learning partner. At this time the learning partner and the orientee will discuss the progress made towards reaching competency level and should establish goals for the next performance period. The trend of the performance will be summarized as either declining, maintaining or advancing.

End of Orientation The end of orientation is established based on an agreement between the orientee, the learning partner, and the manager that the orientee is able to function independently and the majority of the goals and competencies have been met. The CBO Tool should be documented to reflect the attainment of established goals. At this time, goals for the next six months are established. They may include competencies that there was no opportunity to experience during the orientation as well as competencies the individual still needs to meet. The completed CBO Tool is a departmental document that reflects the orientation of an employee. It must be filed with the department manager of the process is not complete.

The Meaning of Competency:

The word competency is heard frequently in the healthcare industry. Competency is an expectation that both JCAHO and AMC have of employees. JCAHO ensures that quality healthcare is provided uniformly. The standard on competency states “The leaders ensure that the competencies of all staff members is assessed, maintained, demonstrated, and improved continually.”

Competency is the ability to do you job. It is not enough to know your job. For example, it is not enough that a football player know how to play the game- he needs to actually be able to play it. Jobs require many different technical skills as well as skills such as critical thinking, values, interpersonal relationships and compliance with organizational policies and procedures. Doing a job well means meeting certain standards of performance in a variety of situations. Competency is applying knowledge and performing skills in real work situations. 7. Recognition  New staff member’s suggestions for ideas to improve strategies and methods of doing the job are listened to and acknowledged  Staff member’s accomplishments, no matter how small or large, are recognized by the manager and other staff

Reversing the cycle to build a culture of recognition and thanks starts with management. Everyone wants recognition for a job well done! It is human nature! Managers need to value and recognize their team for what each of us brings to our work everyday.

The New Hire Survey questions indicate that belonging, recognition, and contribution are extremely important elements to the success of the orientation process. Staff link recognition to being cared about. Even the smallest gesture of recognition for a job well done, can make a great difference to the team or team members. It is one of the most powerful motivating factors for the team.

The manager is the key to recognition. Recognition is the most inexpensive, easy to use motivational technique available to management. Recognition needs to be timely and sincere. If the team needs recognition, then do something for all of them. Rewarding the team leader minimizes the contribution of the team members. Balance rewarding the individual initiative and team efforts without one overshadowing the other. If the team really needs building, then reward the team. In a team based organization, strategies need to be in place so that the recognition does not come just from the managers.

Recognition encourages and reinforces the kind of behavior and improvement activities that we need to drive to a high service-quality organization. Often we minimize the importance of the personal, non-monetary recognition and staff incentives.

8. Contribution  Performance expectation are clearly communicated to new staff members  New staff members clearly understand how the work they do contributes to the achievement of the goals and success of the department

Developing a sense of contribution in an employee assures new staff is aligned on the department mission and goals. Every staff member must clearly understand the mission of the department and the impact each individual must play in achieving that mission. The manager must take the time to help the new employee understand how their role impacts the work of the department, other related departments and the entire effectiveness of Albany Medical Center.

The department mission is openly displayed and discussed in open forums. The mission statement is not just words on a piece of paper, but a document that inspires and truly reflects the work of each individual staff member.

The manager needs to take the time to describe the ‘through-put” process of the department~how does the department impact other departments and the patient. It is vitally important for the new employee to realize that each and every decision has a “ripple” effect on many people and departments The manager should openly discuss how having diverse group of staff members adds value to the team.

9. Organizational Value  The new staff member has a clear idea of how their job fits into the Mission, Vision and Values of Albany Medical Center  The new staff member feels valued by the organization through their initiative and performance

As a valued team member of AMC, each employee commits to and is recognized for their daily contribution of value, initiative, and performance excellence, that links them to the AMC Mission, Vision and Values.

10. Resources  Resources are available to support the orientation process: *Human *Material/Technological *Financial *Problem solving and support  Learning options and resources for the departmental orientation are defined and available.

The manager must work to assure that the resources needed by the Learning Partner and new employee are available. Having adequate resources to support the orientation helps to assure a positive outcome. Not every staff member has the interest, willingness or talent to function as a Learning Partner for new employees. It is important that Learning Partners are selected from among staff members that do have the characteristics needed for success in this role. This has to be a purposeful and pre-determined process so that the Learning Partners can be selected for the new employee.

Everyone plays a vital role in the retention of employees. It is ever so important to continued success, that each team member recognize their part in embracing a new hire as part of a team.

Role and Responsibility of the Learning Partner:

As a Role Model:

 Knowledgeable and Competent  Promotes environment of the “lifelong learner”  Problem Solver  Flexible  Positive influence at all levels regarding department operations  Follows policy and procedure  Uses resources appropriately  Someone who knows their own strengths and weaknesses  Maintains effective working relationships

As a Socializer:

 Recognizes importance of first impressions  Creates and maintains positive learning environment  Assists learners through ‘reality shock’  Integrates activities that promote a sense of belonging  Introduces orientee to fellow team members  Ability to share the ‘unofficial’ rules and guidelines of the culture of the unit and department  Knows of the social activities and encourages participation  Takes the orientees personal life into consideration

As an Educator:

Effective communicator Stays current with changes in process and procedure Passionate about teaching and mentoring Good listener Understands that different approaches make work for different orientees; understands learning and learning styles Uses competency based orientation tools Promotes independence Builds confidence and self esteem Not afraid to say ‘they do not know’

Generational Differences in Learning Expectations… BABY BOOMERS (46 – 63 years of age)

GENERATION X (25 – 45 years of age)

MILLENIALS (24 years of age and younger)

BABY BOOMERS: Want to be responsible for their own learning Expect caring and fairness, want to shine Expect you to tell them what is important and for you to know their name Dialogue and participation is key, want a chance to talk and show what they know Do not like to be bossed around and want to be treated as equals Want you to acknowledge what they know, want their experience to be respected Want to be treated as if they are young even if they aren’t GENERATION X: Prefer to work independently with self- directed projects Humor is important, want a relaxed, fun environment Want information but not hype, talk with them not at them Prefer visual and dynamic presentation Like bullets and graphics – only read what is necessary Expect competence and clarity with presentations along with technology Want solutions to specific and practical problems Learning must have practical value, education is a way to get ahead Clear expectations, directness, and truthfulness is valued

MILLENIALS: Interaction with colleagues important Value clear expectations, structure and direction Expect teamwork in learning with technology, like to move and are interactive learners Want attention from authority and expect teachers to know more than they do Are readers, so provide information in writing Want training in people skills, information that will make lives less stressful, more marketable Want instantaneous and frequent feedback Want to make money

This is meant only as a guide…do NOT stereotype. Always seek to understand what your orientee feels about learning and how they learn best. -Information adapted from research done by Peggy Blake- Gleeson, PhD Adult Learning Principles

1. Adults like to determine their own learning experience 2. Adult enjoy small group interactions 3. Adults learn from other’s experiences as well as their own 4. Adults hate to have their time wasted 5. Adults are motivated to learn when they identify they have a need to learn 6. Adults like some lectures but all lectures won’t be liked by all adults 7. Adults are motivated to learn when societal or professional pressures require a particular learning need 8. Adults are motivated to learn when ‘others’ arrange a learning package in such a manner that the attraction to learning overcomes the resistance. 9. Adults draw their knowledge from years of experience and don’t change readily 10. Adults want practical answers for today’s problems 11. Adults like physical comfort 12. Adults enjoy practical problem solving 13. Adults like tangible rewards 14. Refreshments and breaks establish a relaxed atmosphere and convey respect to the learner Learning Style Inventory Exercise:

In the line provided next to each word, rank each line 1 – 4 (1 = Least 4 = Most) as to how the word noted best describes your learning style:

A B C D 1. Discriminating Tentative Involved Practical ______2. Receptive Relevant Analytical Impartial ______3. Feeling Watching Thinking Doing ______4. Accepting Risk –Taker Evaluative Aware ______5. Intuitive Productive Logical Questioning ______6. Abstract Observing Concrete Active ______7. Present – Reflecting Future – Pragmatic Oriented Oriented ______8. Experiences Observation Conceptualizati Experimentatio _____ on n ______9. Intense Reserved Rational Responsible ______

TOTAL COLUMN TOTAL COLUMN TOTAL TOTAL COLUMN A: B: COLUMN C: C:

______

Total from D - Total from B = ______(plot this number vertically on the grid, can be a negative number) Total from C - Total from A = ______(plot this number horizontally on the grid, can be a negative number)

LEARNING STYLE TYPE GRID:

-6 ACCOMMODATOR DIVERGER -5

-3 -2 -1

17 15 13 12 11 10 9 8 7 6 5 4 3 2 1 0 -1 - 2 -3 -4 -5 -6 -7 -8 -9 -10 -11

7 CONVERGER ASSIMILATOR 8

Once the values have been plotted, connect the dots to determine your predominant learning style

ACCOMMODATOR/ENTERTAINER:

As Teacher: . Assumes people are interested in what they have to say . Likes to use symbolism, imagery and creative mechanisms . Tends to ‘shoot from the hip’ . Tends to follow impulse . Presentation of information may be viewed as chaotic

As Learner: . Enjoys looking at things from many perspectives . Has a broad range of interests . Is creative and dislikes routine and authority . Has a need to develop own way of doing things . Likes to get information in more than one format, multi-sensory . Gets uneasy if not enough action . Ask: “What if?” . Seeks new possibilities, excitement

CONVERGER/LEADER:

As Teacher: . Seeks efficiency and useful information . Enjoys practicing technical skills . Is a decision maker . Enjoys being at the center of the meeting . Usually has well-planned meetings . Tends to be firm as a disciplinarian . Enjoys acting as a coach for practical experiences

As Learner: . Is matter-of-fact work and efficiency oriented . Prefers a single correct solution to issues . Is a step-by-step problem solver . Is poor at speculating and improvising . Can work well (and independently) from clear instructions and good documentation . Asks: “How?” . Like to work with things rather than people

DIVERGER/RELATOR:

As Teacher: . Is empathetic facilitator of human relationships . Desires authentic interactions . Seeks meaning and integrity . Is non-judgmental and supportive . Prefers open discussion and small groups . Will often try to individualize information . Dislikes paperwork, would rather do it themselves . Creates own report format

As Learner: . Is people oriented and empathetic . Is influenced by peer group . Likes collaboration and participation . Needs a sense of social unity . Needs personal attention and feedback . Prefers personal communication rather than memo’s . Has a vivid imagination . May be hypersensitive to hostility and conflict . Asks: “Why?” . Are insightful and imaginative

ASSIMILATOR/INTELLECTUAL:

As Teacher: . Is idealistic, systematic, organized . Likes facts and details . Values sequential thinking . Is more interested in data than people . Prefers ‘informational’ forms of communication such as reading and presentations . Can sometimes be oblivious to the emotional climate in the room

As Learner: . Enjoys abstract concepts and theories . Is critical thinker . Prefers getting data from reading and presentations . Needs a sense of personal control . Often sees play as wasteful . Often needs help is establishing priorities . Asks: “What?” . Seek intellectual recognition

‘TOOLS’ for the Learning Partner THE ASA VI JOB DESCRIPTION: (if another job description is needed, please see Administrative Assistant)

Albany Medical Center Job Description

Job Title: ASA VI (Registrar, Insurance Verification Associate, Pre-Admission Coordinator, Bed Access Coordinator)

Department: Patient Access

Reports To: Manager, Access Services- Registration Manager, Access Services- Emergency Department Manager, Access Services- Bed Access Manager, Access Services – Revenue Cycle

I. QUALIFICATIONS:

1. Required Education, Experience and Skills:  High School Graduate or equivalent plus at least 2 years applicable experience or AAS with 1 year applicable experience or combination of some college and 1 year experience.  Working knowledge of computer based applications and strong PC/keyboard skills.  Applicable experience per Patient Access ASA Hiring Guidelines

2. Preferred Abilities, Knowledge and Skills:  Working knowledge of hospital registration , pre-registration or financial counseling.  Understanding and working knowledge of medical insurance benefits, managed care, Medicaid and Medicare regulatory requirements.  Knowledge of medical terminology.  Working knowledge of healthcare reimbursement standards.  Knowledge of Patient Bill of Rights and Advanced Directives  Strong attention to detail and demonstrated ability to use sound judgment in decision making.  Excellent organizational skills with demonstrated time management skills.  Ability to handle high workload volume.  Excellent customer service skills and ability to communicate effectively both written and verbal.  Ability to be flexible and demonstrated ability to be adaptable.

I. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

 Pre-register/register patient information for inpatient and outpatient ensuring accurate capture of demographic, guarantor and insurance information.  Ensure those services requiring pre-certification and /or pre-authorization are completed in accordance with regulatory or contractual agreements.  Review of inpatient admissions to ensure payment source is secured in accordance with regulatory or contractual agreements.  Ensure appropriate and timely referrals of self pay accounts to the Medicaid Eligibility Unit to ascertain Medicaid eligibility status.  Promote excellent customer service to internal and external customers.  Coordinates bed placement for inpatients, transfers, bedded outpatients  Completes paperwork and coordinates all arrangements for expirations

II. SPECIFIC RESPONSIBILITIES

2. Obtain and verify patient demographic, guarantor and insurance information for new or established patients either by telephone or face to face for inpatient and outpatient population in accordance with departmental policy.

3. Create a patient/case record in the ADT registration system in accordance with established policy and procedures for inpatient, ambulatory surgery, non-patient laboratory, radiology and/or other diagnostic ancillary tests/services.

4. In conjunction with Patient Triage Manager, coordinates all bed placement for inpatient, transfers and outpatient bedded requests

5. Analyze insurance information/reason for admission or encounter to determine pre-certification and/or pre-authorization requirements.

6. Contact insurance carriers to obtain pre-certification and pre-authorization numbers. a. Contact patient’s as needed to verify data or obtain information.

7. Ensure the patient record is updated with accurate information and the insurance record reflects all appropriate insurance, appropriately prioritized. (coordination of benefits) a. Ensure patient account is secured for payment prior to discharge/encounter.

8. Inform patients of Advanced Directives, Patient Bill of Rights, Financial Agreement and general patient information about their hospitalization/encounter.

9. Ensure all self pay accounts are referred to the Medicaid Eligibility Unit to ascertain eligibility status in accordance with policy and procedure.

10. Ensure all admissions via Emergency Room are counseled prior to discharge. 11. Completes all expiration paperwork and coordinates all appropriate arrangements with Funeral Directors for all expirations.

12. Ensure all deductibles and co-payments are collected in accordance with insurance benefits and departmental policy for inpatient and outpatient population.

13. Ensure patients are apprised of advanced beneficiary notice, as appropriate and in accordance with Medicare Medical Review Policies.

14. In accordance with departmental policy and procedure, follow up on Billing Hold Reports, Missing Utilization Threshold Reports, Denial reports.

15. Provide cross coverage to other units as needed.

16. Assist in other projects as needed and as directed by management.

17. Assist as needed, as directed with training new personnel, either demonstrating a process, acting as a learning partner or providing direct training.

18. Review and respond to quality monitors in accordance with departmental policy.

19. Adheres to AMC Corporate Compliance Plan including responsibility for internal reporting of non- compliance to plan.

Created: June 2001 Reviewed/Revised: January 2004; September 2004; October 2004

Patient Access: Department Orientation TABLE OF CONTENTS

1. General Department Information Department/Unit Description...... 1 Patient Access Mission Statement...... 3 Patient Access Organizational Chart...... 4 Delineation of Responsibilities...... 5 Personal Leave Time...... 6 Tardiness Policy...... 10 Holiday Pay Reimbursement Guidelines..15 Departmental Communication Methods...27 Quality Improvement Team (QIT)...... 28 Voice Mail Guidelines...... 29 Maps...... 30 Employee Health...... 33 AMC Occurrence Report...... 34

2. Job Specifics Career Opportunities...... 36 Job Descriptions...... 37 Annual Training Requirements...... 41 Annual Competency Assessment...... 42

3. Customer Orientation* AMC Excellence in Customer Service.....50 Customer Orientation...... 53 Greeting Customers...... 54 E Mail Etiquette...... 55 Patient Expectations...... 56 Getting to What Customers Want...... 57 Learning How We Affect the Customer....58 Being Flexible & Solving Basic Problems 59 Handling Tough Situations...... 60

* Customer Orientation & HIPAA Education will be oriented in formal, scheduled sessions with Quality & Development. 4. Institutional Overview A. Albany Medical Center’s Strategic Plan...... 61  AMC’s Mission...... 67  AMC’s Vision...... 68  AMC’s Values...... 69 B. Code of Conduct...... 70  Patient Bill of Rights...... 83 C.Regulatory Agency Overview...... 85  Corporate Compliance...... 86  U.S. Department of Health & Human Services (HHS)...... 87  Office of the Inspector General.....87  Centers for Medicare and Medicaid Services (CMS)...... 88  Joint Commission on Accreditation of Healthcare Organizations (JCAHO)88  New York State Dept. of Health....89  EMTALA...... 89

5. HIPAA Education*...... 90

6. Orientation Follow Up Orientation Checklist Orientation Follow Up Checklist 30-Day Orientation Follow Up Checklist New Hire Orientation Schedule Document Compliance Checklist

7. Forms to be Completed Acknowledgement of Orientation Emergency Information Sheet Patient Access Confidentiality Policy Confidentiality Statement Code of Conduct Acknowledgement Annual Competency & Education Record “Show Me” Safety in My Work Are ALBANY MEDICAL CENTER Departmental Employee Orientation Checklist

Please review each item with the new employee during the first week of employment. The completed form is to be retained by the department as part of the employee’s record of orientation/competency file.

I. General Department Information/Work Practices  Personal Leave Time  Department/Unit Description  Holiday Pay Reimbursement Guidelines  Patient Access Organizational Chart  Tardiness Policy  Voice Mail Guidelines  Departmental Communication Methods  Employee Health  Introduction to Department Managers  AMC Occurrence Report  Introduction to Co-Workers/Staff Directory  Professional Image Standards  Standard Precautions/Blood Borne Pathogens  Tour/Facilities for Employees  Security/Swipe Access/Keys ___ Bolton Hall  ID Badge  Department PI Initiatives and Process (Quality Plan)  Lockers/Storage of Personal Items  Smoking  Pay Rate  Department Telephone Numbers  On-Call  Public Relations and Media Inquiries  Time cards  Human Resource Information Centers  Department Meetings  AMC Publications  Equipment (including personal use of equipment):  Open Forums  Department Specific Equipment  Patient Access Mission Statement  Office Equipment (Copier, Fax, Telephones, etc.)  Delineation of Responsibilities  Equipment Manuals/Help Desk  Problem Solving Policy  Uniforms, Lab Coats, etc.  Solicitation Policy  Precautionary Training  Department Goals and Objectives  Physical work space  Supplies II. Job Specifics  License/Certification Renewal  Training Schedule, Learning Partner  Annual Training Requirements  CBOT  Career Opportunities/Job Posting  Annual Competency Assessment  Job Descriptions  Registration System  Resources Manuals (Intranet, Patient Access)  Annual Physical Assessment

III. Customer Orientation  Training by Quality & Development (Incorporate AMC’s Customer Orientation Standards) IV. Institutional Overview  Charity Care  AMC’s Mission, Vision & Values  Emergency Preparedness Plan/Emergency Codes  Code of Conduct/Cultural Values/Religious Beliefs  Albany Medical Center’s Strategic Plan  Patient Bill of Rights

Regulatory Agency Overview:  Department of Health & Human Services  Corporate Compliance/Conflict of Interest  Office of the Inspector General  New York State Department of Health  Joint Commission on Accreditation of  EMTALA Healthcare Organizations (JCAHO)  Centers for Medicare and Medicaid Svcs.

V. HIPAA Education  Training by Quality & Development  HIPAA Training/Test Completion (Competency)

VI. Orientation Follow Up  Orientation Follow Up Checklist  Orientation Checklist  New Hire Orientation Schedule  30-Day Orientation Follow Up Checklist  90-Day Orientation Survey  Document Compliance Checklist

VII. Forms to be Completed  “Show Me” Safety in My Work Area  Acknowledgement of Orientation  Training Expectations  Emergency Information Sheet  Code of Conduct /Patient Bill of Rights Acknowledgment  Patient Access Confidentiality Policy  Annual Competency & Education Record  Confidentiality Statement

VIII. New Hire Preparation Checklist  Business Cards  Voice Mail/telephone number  Keys and Swipe Access  E-mail, Intranet, Internet  Furniture  Novell Sign-on for Network Access  Desktop/Printer  Invision Security  Commercial phonebook  Beeper/Cell Phone  Work space  Door Sign

The above items have been discussed with me and I understand them.

______Employee Signature Date

______Hiring Manager Signature Date PATIENT ACCESS:

Competency Based Orientation Tool (CBOT)

**CBOT separate document GUIDELINES FOR THE USE OF THE COMPETENCY BASED ORIENTATION TOOL

Initiating Department/Unit Orientation Each new employee is given a copy of his or her Competency Based Orientation (CBO) Tool. At this time, the orientee is expected to complete the Self-Evaluation Section of the tool (left column). For each Competency, the orientee is to indicate the level that best identifies his/her knowledge and/or skill according to the following scale:

#1. The orientee has NO FAMILIARITY with the theoretical content and required skill performance.

#2. The orientee has prior knowledge of the theoretical content and/or required skill; however she/he NEEDS A REVIEW of the theoretical content and/or supervisory instruction for skill performance.

#3. The orientee is COMPETENT with the theoretical content and skill performance.

The learning partner/preceptor, assigned the responsibility for the orientee's progress, reviews the self- evaluation for the purpose of summarizing the orientee’s learning needs for the orientation.

During Department/ Unit Orientation The overall performance of the orientee is reviewed and summarized at regular occurring intervals. The department determines the frequency of consistent review. The CBO Tool is documented with the orientee's progress continuously and summarized during the review intervals. The performance period depends on the length of the orientation and the needs of the orientee, i.e. weekly or monthly. The average length of orientation is (to be completed by specific dept./unit).

At the end of each performance period, the learning partner and orientee will discuss the progress made toward reaching competency and should establish goals for the next performance period. Self-evaluation and the learning partner summary are documented on the Goals/Progress Towards Competency pages. The orientee should record experiences that substantiate in his/her opinion the progress of orientation.

The trend in the overall performance of the orientee is evaluated according to criteria defined on the goal pages. Performance is declining, maintaining, or advancing.

The Competency Based Orientation Tool, is comprised of: Competency statements (found at the beginning of each section) are broad range goals that need to be completed by the end of orientation.

Performance Criteria are behavioral objectives, which, upon completion, will provide evidence of attainment of each Competency Statement. If any Performance Criteria is not met by the end of orientation, it will be noted as a continuing goal with the expectation that it will be achieved within an established time period.

Documentation of the Validation of Learning is recorded next to each performance criteria on the competency tool by recording the code for the method (see legend on tool) with which competency was validated. The preceptor must verify that the orientee has attained the listed skills. Learning Options/References are specific resources that can be utilized to aid the learning process and to meet the Performance Criteria. These are maintained in the department binders/manuals of learning materials.

End of Orientation In collaboration with the orientee, it is the responsibility of the learning partner to complete documentation of the tool by the end of orientation. At this time, the orientee, preceptor, manager, and resource staff meet to determine the orientee's ability to practice independently, complete the CBO and establish goals for the following performance period (6 months). The orientee will be asked to complete the Orientation Process and Preceptor Evaluation. The preceptor and orientee will both sign the completed CBO, signifying completion of orientation.

After Orientation The CBO completed packet is given to the manager. The completed Competency Based Orientation Tool is filed in the department. Any unmet goals listed on the last goal forms will be evaluated at the next performance period (i.e. 6-month evaluation).

Patient Access: Competency Based Orientation Process & Learning Partner Evaluation

Name: ______Learning Partner: ______

The Orientation was effective in meeting your needs: YES No Comments to support evaluation

1. The competency based tool and educational resources were effective in meeting your needs. 2. The orientation was well planned and progressed in a logical manner. 3. You had a consistent learning partner. 4. Your learning partner was a good role model and resource. 5. Your learning needs were assessed and orientation was individualized accordingly. 6. You were given an opportunity to function independently that was consistent with your level of expertise. 7. Feedback was provided by your learning partner on a daily basis. 8. Your learning partner reviewed plans for your orientation weekly. 9. Your learning partner was able to provide theoretical knowledge and assistance and assistance with operational skill effectively. 10. Support systems were available to you as a resource and promoted the planned orientation process. 11. The unit environment promoted a consistent learning process. 12. (If applicable) Shift rotations contributed to the learning process. 13. Your previous professional experience was acknowledged. 14. Open communication was maintained through the orientation process with the learning partner, manager/supervisor and others.

The most valuable aspect of orientation was: ______

Suggestions for unit orientation improvements are: ______

Patient Access Learning Partner Self Assessment

Name: ______Learning Partner:______

The learning partner experience was successful: YES NO Comments to support evaluation: 1. I effectively articulated process and procedure with little misunderstanding on part of the orientee. 2. I felt that the orientation/training was well planned and met the needs of the orientee. 3. I was able to be a consistent learning partner. 4. I felt I was a good role model and resource to my orientee. 5. I had ample time to assess and individualize the training as needed. 6. I was able to provide an opportunity for the orientee to work independently with level of expertise. 7. I provided feedback on a daily basis and it was received well. 8. I reviewed the days training plan with the orientee. 9. I was able to provide practical examples and knowledge to the understanding of the orientee. 10. Systems support and resources promoted the planned orientation process. 11. The unit environment promoted a consistent learning process. 12. I acknowledge the previous experience of my orientee. 13. I maintained open communication through the orientation process with my orientee and manager/supervisor.

I felt the most valuable aspect of the orientation plan for this learning partner was:

______

Suggestions for unit orientation improvements are:

______Why is the Learning Partner role important? :

 Provides a different point of view  Provides point person of contact for questions  Individual growth as a learning partner – including diversity and exposure to all different situations  Improves communication skills  Fosters long term relationships for the learning experience to continue  The role is responsible for making connection and establishing interrelationship with other staff including clinical; ensuring there is not total self-reliance on learning partner  Provides the ability for orientee to identify other resources  The learning partner role provides confidence to the orientee in the department and AMC  Helps the learning partners’ ongoing training  Let’s orientee know its “ok” not to know something  Learning Partner provides feedback to orientee and manager regarding training pace and progress  Provides feedback to orientee on resolutions to issues or questions  Show which way the “wind blows”; the unofficial “code system”

Obstacles to being an effective Learning Partner:

 Time constraints due to workload; staffing shortage  Learning Partner’s reaction to learning pace  Policy and procedure – ensure the complete policy and procedure is trained  Fast paced environment; balancing multi-tasking with pace of orientee learning  Trainee lack of confidence  Balancing the asking/answering of questions vs utilizing resources to find the answer  Frustration demonstrated by orientee about the learning partner or training experience  Other staff not permitting the learning experience to occur or opportunity to train a specific situation does not present during the formal training period  Adapt learning partner presentation to trainee personality

The Manager’s Role:

. Choose the appropriate Learning Partner . Explain responsibilities of the Learning Partner . Evaluate process and progress of the orientee; including the Learning Partner and Orientee relationship . Promote ample to time for effectively train and orient new hire . Establish goals for the Learning Partner

Manager – Learning Partner and Orientee Review

It is important as the Learning Partner you gain the confidence in the assessment and evaluation of an orientee’s progress. Their success is the department’s success.

Utilizing the tools in the Learning Partner process, will enable you to convey areas that require focused training or additional remediation. Please be sure to provide this information to your manager during your scheduled review sessions.

During the review sessions, the manager will be guiding the review and possibly posing questions to yourself and the orientee. Identification of issues should always be done with tact and diplomacy. If you feel an area requires a conversation with your manager and yourself, without the orientee present, feel free to request some time with your manager.

Most important, we all want the new team member’s orientation to be complete, thorough, interactive and non-imposing. It is as important that the orientee feels comfortable to request needing additional assistance as it is important that you are comfortable in recommending the need.

REMEMBER: Learn Explain Acknowledge Recommend Negotiate

Thank you for your commitment and dedication to the department’s orientation and training program..We could not do it without you!