Case Study
Building a Scalable Onboarding System to Improve Employee Experience, Manager Readiness, and Retention
The Challenge
A level 2 hospital system was experiencing growing concerns around new hire retention, onboarding effectiveness, and employee experience. Leaders were seeing an increase in:
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Employees leaving within the first 3–6 months of hire
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New hires requesting transfers shortly after joining departments
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Poor hiring matches and challenges with role acclimation
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Rising employee relations concerns
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Inconsistent onboarding experiences across departments
At the center of the issue was an onboarding process that lacked structure and continuity.
Day 1 New Hire Orientation consisted of an 8+ hour, lecture-heavy experience that received moderate satisfaction ratings (3.5–4.0/5) and recurring feedback around:
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Information overload
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Limited engagement
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Excessive paperwork
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Generic content that lacked role relevance
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Inconsistent facilitator effectiveness
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Little connection between orientation and real-world job success
Beyond Day 1, departments operated independently with no standardized onboarding process to guide leaders in acclimating employees to their teams, workflows, culture, or expectations. The result was that new hires were often left to “figure it out,” creating variability in experiences, slower assimilation, and increased risk for early turnover.
The organization needed more than an orientation redesign but an end-to-end onboarding strategy that improved employee experience while strengthening retention and leader capability.
The Intervention & Work
We designed and implemented a comprehensive onboarding system that transformed onboarding from a one-day event into a structured employee experience journey.
Phase 1: Assess & Identify Gaps
We partnered with leaders and stakeholders to evaluate the current onboarding experience, identify friction points, and understand the drivers impacting retention and employee sentiment.
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Key focus areas included:
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Orientation effectiveness
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Department onboarding inconsistencies
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Manager readiness and accountability
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Employee acclimation experience
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Transition points across the employee lifecycle
Phase 2: Redesign the New Hire Experience
We completely reimagined Day 1 orientation by moving away from a passive information dump toward a high-engagement learning experience.
Enhancements included:
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Reduced orientation length from an 8-hour experience to a streamlined half-day format with lunch provided
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Interactive activities and knowledge checks
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New Hire Expo model connecting employees to resources and support partners
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Updated facilitation strategies to increase engagement and retention of information
Phase 3: Build Manager Enablement Infrastructure
Recognizing that onboarding success extends beyond orientation, we developed tools to strengthen leader capability and create consistency across departments.
Resources included:
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Manager Enablement Hiring Toolkit
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Customizable hiring guide templates
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Standardized onboarding expectations
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Departmental Onboarding Roadmap Toolkit
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Structured onboarding plans leaders could adapt by role
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Clear learning milestones and acclimation checkpoints
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Guidance for role integration and performance readiness
Phase 4: Create a Peer Support & Integration Model
To improve connection, belonging, and transition into the organization, we designed a 90-Day Onboarding Ambassador Program for both clinical and non-clinical employees.
Program components included:
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Onboarding buddy assignment process
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Ambassador training curriculum
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Standardized expectations and support checkpoints
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Relationship-building strategies to improve employee integration and experience
The Outcomes & Impact
The onboarding transformation shifted onboarding from a transactional event to a strategic employee experience initiative.
Results included:
Employee eNPS increased 7 percentage points within two quarters
Additional outcomes included:
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Average new hire onboarding satisfaction rating of 4.89/5 across 2 quarters
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Improved onboarding consistency across departments
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Increased manager readiness and accountability
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Better new hire integration and acclimation
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Stronger employee experience from Day 1 through the first 90 days