Orienting a new PA hire

Orientation of a PA goes beyond simply showing them where the break room is or how to navigate your electronic health record system.

A thoughtful orientation process enables the PA to understand the practice, patients, staff, culture and the approach the practice takes to delivery of health care services.

The PA Employer Checklist to Orient a new PA hire

1) Pre-Orientation

• PA to complete all necessary HR paperwork and documentation. This includes reviewing and finalizing the employment contract, submitting criminal record checks, vaccination status, proof of PA certification, proof of malpractice/liability insurance coverage and proof of membership to CAPA.

• Share relevant documents: Share with the PA policies, procedures, standards of practice, relevant medical directives, and any relevant employee handbooks

• Communication Memo to Staff: Email the department and staff about the new PA hire, including a brief bio with photo headshot. Include some information about the scope of the PA role.

• Complete relevant training: whether in-person or online such as WHMIS training, Fire & Safety, EMR e-learning modules (if applicable), scrub sessions, n95 mask fitting

• ID Badge: Obtain hospital/workplace ID badge which provides access to relevant sites

• Locker Access: If applicable, for example if PA will be surgical assisting in the OR; access to the OR bootroom and a locker is required.

• Provide a Workspace: Ensure your new PA has a designated workspace equipped with the necessary tools and resources to perform their duties.

2) Electronic Medical Records (EMR) and IT Systems Access

• EMR Login and Access: Provide the PA access to the EMR with a unique login, and necessary permissions for patient care including documentation and the ability to place orders.

• Dictation Login: For hospitals that continue to utilize phone dictation, provide dictation login credentials and instructions on performing dictations.

• Hospital/Practice Email: Provide PA with workplace/hospital email to correspond with other staff, allied health care providers and patients confidentially.

• Pager: if relevant to the PA’s duties, provide the PA with access to a pager.

• Train the PA on EMR usage: Provide training on how to access and navigate patient charts, document encounters, order tests, and generate prescriptions. Highlight the importance of accurate and timely documentation to ensure continuity of care and facilitate effective communication within the healthcare team.

3) Welcome and Introduction:

• Tour: Provide a tour of the practice facility, orienting the PA to all the clinical areas where they will be practicing.

• Introduce the PA to the healthcare team and key personnel

• The supervising physician and PA first meeting: Assign a mentor or preceptor to the PA during the orientation period. This may be a PA that is already working the practice, or a physician. The new PA hire and supervising physician should meet on the first day, and discuss:

  • Expectations of the PA - roles, responsibilities and performance standards

  • Discuss PA/MD supervisory relationship and establish open lines of communication

  • PA learning objectives

  • Reiterate scope of practice and any limitations or restrictions to practice - review use of medical directives

  • Provide resources for learning.

• Provide Contact Info & Resources: Include contact information of key personnel that the PA may reach out to for further help (e.g. IT setup, dictation setup, badge access to hospital, scrubs, etc.)

4) Familiarize the PA to Practice Workflow

• Create a shadowing schedule: It is common to have a new PA hire shadow the supervising physician or other senior PAs for the first few days or weeks. The new PA hire should spend time shadowing in all clinical areas they will eventually work in (clinic, on the ward, on-call, operating room, etc.).

  • This period of shadowing will allow the PA hire to to understand practice workflow, dynamic of how clinicans interact with staff and patients, and standards of practice for patient care in your particular practice setting/department.

  • Note: According to the Ontario Employment Standards Act, time spent training that is required by an employer for continued employment is considered work time, and therefore should be paid. This includes shadowing or working “trial shifts”.

• Foster Collaboration: Have the PA participate in interprofessional rounds, team meetings, and encourage them to seek input from colleagues, participate in interdisciplinary meetings, case discussions, and care coordination efforts to optimize patient outcomes.

• Discuss the importance of introducing the PA to the workflow processes: Explain the steps involved in patient intake, from check-in to rooming, and provide insights into how various healthcare professionals collaborate during a patient's visit. Clarify expectations regarding patient interactions, assessments, diagnostics, and treatment plans, ensuring alignment with your practice's standards.

• EMR Orientation: Provide training on how to access and navigate patient charts, document encounters, order tests, and generate prescriptions. Highlight the importance of accurate and timely documentation to ensure continuity of care and facilitate effective communication within the healthcare team.

• Documentation: Provide the PA with examples of past dictations or documentation, or access to EMR templates that are commonly used by staff in that department.

5) Provide Specialty-Specific Training

• Offer a review of cases for quality assurance and learning purposes: The supervising physician or PA already working/experienced with the practice can review cases with the new PA hire, review documentation, and provide insight and guidance around approach to patient assessment and treatment. This direct supervision is usually only for a brief period until the PA is comfortable.

• Case based learning: 1-on-1 mentoring with review of relevant cases with the supervising physician. this can include review of cases PA has seen when starting, or simulated patient cases.

• Mentorship and Collaboration:

• Procedural Training: If the PA hire will be performing specific procedures, offer hands-on training/supervision.

• Specialty-Specific Resources: Access resident teaching rounds (if available), coursework, conferences, webinars, workshops, textbooks, and medical journals related to the specialty.

5) Frequent Check-ins and Ongoing Support

• Establish regular check-ins with the PA to address any concerns or questions.

• Offer continuing medical education (CME) and continuous professional development (CPD) opportunities to enhance their skills and knowledge.

6) Conduct Quarterly/Semi-Annual PA feedback and performance reviews

• Provide opportunities for feedback and evaluation of the PA's progress. Feedback and performance reviews play a crucial role in setting expectations, clarifying goals, and fostering open communication within your practice. This helps identify areas for improvement, and opportunities to recognize achievements and milestones that improve morale and promote retention. Click here to learn more about conducting PA feedback and performance reviews.

Final notes

By following these steps, you're not only equipping your new PA with the necessary knowledge and skills but also creating an environment that values collaboration, patient-centered care, and professional growth.

The orientation process is just the beginning of their journey, and ongoing support and mentorship are essential for their long-term success.