BackgroundSuccessful orientation speeds up the adaptation process by helping new employees feel comfortable in the organization and by making them more productive on the job. In today’s world most organization are recognizing that this type of simple generic orientation is not enough, a more complex employee orientation or on boarding process is required.ObjectiveTo assess induction and orientation practices and perceived effect on health work force performance and satisfaction in public hospitals of Ilubabour zone, Oromia regional state, south west Ethiopia, 2018.MethodsA Facility based cross sectional study was conducted by using both quantitative and qualitative methods. Quantitative data was collected by self-administered questionnaire and qualitative data was collected by in-depth interview with purposefully selected key informants using interviewer guide. The sample sizes for quantitative data were calculated by using single population proportion formula. Accordingly, a total of 403 samples were drawn from the source population by stratified sampling technique. Qualitative data of in-depth interview was transcribed, and thematically analyzed and triangulated with quantitative findings.ResultsOut of 388 only 135(34 %) respondents have attended induction and orientation training while assignment to different new responsibilities. The finding from key informants revealed that they take even for less than one day or an hour. Regarding the practices held during the training; only proper welcoming them to the organization and department was practiced, the rest practices like sharing the organization vision, involving senior leaders and post training evaluation was responded that they were exercised poorly within the organizations. Only 53.1% responded that induction and orientation training have perceived effect on employee Performance while 46.7% of respondents do not. About 55.7% respondents said that induction and orientation training have perceived effect on employees’ job satisfaction and the remaining responded to have no effect on employee’s satisfaction.ConclusionGenerally, the induction and orientation practice was poor so as the supportive supervision and post training evaluation. More than half of the respondents perceived that it has effect on performance and satisfaction and the rest did not understand its specific effects.