Development of an Informatics Orientation Program Using Tiered Skills Acquisition Model (TSAM®)

As a result of vast practice support responsibilities for informaticists, as well as a lack of standardized preceptor onboarding approach across a Magnet-recognized healthcare organization, informatics identified a need for an onboarding framework with a universal purpose of preparing the informaticist for independent practice in their new role. With multiple informaticists joining the division over the last 2 years, multiple learning needs were identified throughout the department. Informaticists voiced a desire for an onboarding process advocating for strategies to facilitate learning as well as promote confidence in their new role. Thus, an orientation framework using the tiered skills acquisition model (TSAM) was proposed as a solution to departmental orientation needs across the multi-campus, multi-state healthcare organization.

The TSAM approach was initially developed as an orientation model that utilizes structured tiers of skills progressing from basic skills to complex interventions for newly graduated bedside nurses, but this approach is successful in orienting experienced nurses to new roles in other healthcare settings. Traditional orientation approaches involve the preceptee assuming all responsibilities for a single patient assignment, working their way up to a full patient assignment. With the TSAM approach, the preceptee-preceptor pair begins with sharing a full patient assignment, but the preceptee is only responsible for learning and mastering a set of basic skills at a time and works up to incorporating a new set of skills each time they advance to the next tier.

At the start of 2023, informatics revised the orientation record by incorporating the TSAM structure to orient new hires to the informatics role. This model was selected as it has shown to be a successful evidence-based practice approach in onboarding new staff in the department of nursing across the multi-campus, multi-state healthcare organization. A TSAM workgroup was created that consisted of various Informaticists representing each region who met on a weekly basis for six months. Utilizing expertise and input from experienced informaticists, preceptors, and recent hires, the tiers were developed for the role with specific objectives and tasks aligned for each tier. These objectives, clearly described using action verbs, must be met to demonstrate competency of skills within that tier before the preceptee can advance to the next tier.

With the utilization of a TSAM, the findings show benefits for the newly hired employee as well as nurse leaders, including increase in confidence and retention among the preceptee along with efficiency from cost-savings and orientation length perspectives. Preliminary informatics preceptee survey results show an increase in confidence, as well as feeling supported and prepared in their new role.

Learning outcome: Empower informatics peers to develop a structured onboarding model for newly hired informaticists using evidence-based practice to promote confidence, autonomy, retention, and efficiency within the profession.