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Scholarly Commons > HCA Healthcare Journal > Vol. 7 > Iss. 5 (2026)

 

Keywords

health care workforce; employee onboarding; workflow redesign; process improvement; Great Resignation; health care staffing; operational efficiency; electronic health records (EHR); lean process improvement; health care operations

Disciplines

Human Resources Management | Nursing

Abstract

Background

During and after the COVID-19 pandemic, health care staffing shortages and onboarding inefficiencies, specifically delays in employee health clearance, prolonged time to hire, and threatened workplace and patient safety.

Methods

An employee health onboarding workflow at a large health care organization was redesigned across 3 domains: people, process, and technology. Interventions included workflow standardization, elimination of non–value-added steps, optimized tuberculosis screening, increased appointment capacity, and technology integration (electronic health record [EHR]documentation, centralized scheduling and communication, and completion of pre-visit forms). Following a pilot from May to December 2022, the workflow was expanded organization-wide with a structured rollout and ongoing performance monitoring.

Results

During the May to December 2022 pilot, weekly visit capacity increased 158% (from 12 to 31 visits), mean visit duration decreased 77% (from 163 to 38 minutes), and paperwork time was reduced 50%. No hiring delays attributable to employee health processes occurred during the pilot or subsequent rollout.

Conclusion

Targeted workflow redesign and technology integration significantly improved onboarding efficiency, reduced administrative burden, and enhanced operational performance. These findings support scalable, system-level strategies to streamline hiring, improve workforce readiness, and strengthen workplace and patient safety amid ongoing health care staffing demands.

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