Preceptors are clinicians partnered with newly hired or newly licensed clinicians to provide on-the-job support and skill development. Insurance provider Aetna Inc. used Preceptors for decades, in an informal, non-supported way. The need to optimize the onboarding experience became acute with significant hiring in the Medicare segment, and the need to train thousands of clinicians as a result of the acquisition of Coventry Health Care. In response, Aetna began the transition from an ad hoc Preceptor Program to a robust, structured one.
In early 2012, 300 existing Preceptors were asked to evaluate the current state of the program:
- 29 percent said they got adequate ongoing training.
- 0 percent felt they had adequate soft skills training (feedback, coaching, etc.).
- 50 percent felt they had adequate time to precept.
- 42 percent said they had no support in their role.
Responses to essay-type questions indicated:
- The need for a centralized repository for information
- The need for a standardized checklist or process for reviewing new hire progress
- The fact that there is no standard explanation of responsibility—what the Preceptor does versus what the supervisor does
- The fact that Preceptors felt “it is difficult to keep the new hire occupied and do my own job”
Program Goals
Based on these results, Aetna formed workgroups with the following goals:
- Increase new hire performance, retention, and productivity
- Develop consistent, effective tools and approaches across the National Care Management organization
- Design uniform processes to align and accelerate new hire performance
- Provide skill building and Preceptor community solutions
- Define metrics and assessments to guide success
- Revitalize focus and commitment to Precepting
Program Details
Aetna launched the pilot program in July 2012, as the workgroups continued to refine outcomes. December 31, 2012, turnover in National Care Management was 12 percent, but with more than 150 people hired each month, and the need to have clinicians effectively handling a full workload as soon as possible, this level of termination was not acceptable. Complicating matters, many new hires went directly to work-at-home status, so there was no face-to-face support available from colleagues.
Beginning in January 2013, the new program was introduced enterprise-wide and, with lessons from the pilot, major adjustments were made. At the launch, 65 percent of new hires had Preceptors. An Implementation Team of business leaders was established to promote the program internally and to bring back concerns or issues from their teams, so real-time adjustments could be made. Senior leadership actively promoted the program.
The result of this effort is that as of August 1, 2013, the Preceptor Program includes:
- A redesigned curriculum of six workshops offered twice a month
- Weekly progress reports completed by Preceptors and shared with Supervisors
- Monthly community calls to share best practices and create mentoring opportunities
- A handbook that clarifies roles and responsibilities of Preceptors, new hires, and supervisors
A Community Site includes:
- Calendar of training events
- Activities to reduce the need for Preceptors to create them
- Frequent communication to clarify issues and promote tools
- On-demand training and a presentation for supervisors to use with staff
- A monthly Preceptor Prep call that ensures those with new hires in that month’s class know their responsibilities, where to find resources, and how to use the quality tools
Results
- Turnover is down 50 percent.
- As of July 2013, 100 percent of new hires had a Preceptor.
- 150 new Preceptor volunteers have joined.
Result of three-month post-training surveys of Preceptors and Preceptees:
- 53 percent of new hires manage a full caseload.
- 100 percent of Preceptors said soft skills training is sufficient.
- 97 percent of Preceptors feel the tools and resources are effective.
- 67 percent of new hires have adequate time with their Preceptor.
