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Performance management and evaluation are vital in healthcare organizations, as they ensure that the quality of care provided to patients remains high and that all of the non-patient-facing staff are performing to expectation. As a healthcare manager, performance management should be ongoing, and by regularly assessing employees' performance, healthcare institutions can identify areas for improvement, reinforce best practices, and ensure that care providers meet established standards. Performance management can be through informal feedback in day-to-day interactions, and it can also be more formal through written performance evaluations. Either way, it helps in identifying training needs and building a culture of continuous learning. Performance management is essential for ensuring compliance with regulatory requirements and maintaining accountability, as healthcare organizations are often subject to strict guidelines and safety protocols. Often, the first step in performance management is to establish specific, measurable, achievable, relevant, and time-bound (SMART) goals for each employee. The goals can then be assessed at a specified time, i.e. annually, to determine if the employee has met the goals set for them.
Giving staff regular feedback on their performance is crucial for many reasons. First, it helps employees understand how well they are meeting job expectations and whether they are fulfilling the organization's goals. Regular feedback enables employees to know what they are doing well and where they need to improve, which can guide their professional growth. Constructive feedback encourages open communication, encouraging staff to build on their strengths and address any gaps in their skills or knowledge. It helps employees understand how they are doing and what they can do to improve. Feedback should be specific, timely, and focused on behaviors and outcomes rather than personal characteristics.
EXAMPLE
Don't focus on personal characteristics: “You need to be more attentive.” Do focus on performance and outcomes: “I’ve noticed that some patients have mentioned longer wait times. Let’s work on improving our response times to patient calls.”Ongoing feedback also provides an opportunity for managers to recognize and reward positive performance, which can increase employee motivation, job satisfaction, and engagement. In turn, this leads to higher productivity and better overall team performance. Additionally, feedback allows managers to address issues early before they become bigger problems, preventing misunderstandings or misalignments between staff and organizational objectives. Timely and effective feedback is essential for developing a high-performing workforce, maintaining open communication, and ensuring that staff members feel supported and valued.
Effective feedback should always be balanced, highlighting both strengths and areas for improvement. This helps employees feel recognized for their efforts and motivated to continue improving. For example, a manager might say, “You’ve done a great job with patient care, and your attention to detail is excellent. Let’s also focus on improving our communication with patients to enhance their overall experience.”
There are several popular annual employee evaluation systems used by organizations to assess employee performance, provide feedback, and guide development. Most organizations will adopt one standard system that all managers use. Human resources (HR) typically trains managers in the use of the adopted system and manages the distribution of the documents used and the timelines and deadlines for the evaluations.
Regardless of the evaluation system used, many incorporate a management by objectives (MBO) approach. In this approach, employees and managers collaboratively set specific, measurable, and time-bound objectives at the start of the year. Performance is then evaluated based on whether those objectives were met. MBO encourages goal alignment between individual and organizational priorities and helps employees focus on key performance targets.
The following are some of the most common evaluation systems used.
This system gathers feedback from a variety of sources, including managers, peers, subordinates, and sometimes even customers. An employee is often given the opportunity to choose one of their peers to perform that part of the evaluation. By collecting feedback from a range of perspectives, it provides a well-rounded view of an employee’s performance, highlighting both strengths and areas for improvement. It encourages self-awareness and can reduce bias in evaluations. This method promotes a well-rounded assessment and can increase the objectivity of the evaluation process.
This is helpful because sometimes the manager does not see an employee’s performance at the same level as their peers and subordinates. It is often the people an employee works with day after day who observe their performance more completely than the manager and can offer a more valid evaluation.
In this system, employees are asked to evaluate their own performance over the year. This encourages self-reflection and allows employees to identify their own achievements and areas for growth. It is often combined with manager evaluations to create a more balanced and collaborative review process. Typically, the focus is the use of goals, and staff can determine if they reached each of the goals set in the previous year. If they didn’t meet a goal, they have the opportunity to explain why. They are also asked to reflect on what they can improve on and to set goals for the next year. This is reviewed and discussed with the manager, and feedback is given both ways. When combined with manager feedback, this method creates a more collaborative and transparent evaluation process.
This is a simple and widely used evaluation system where managers rate employees on a scale (typically 1–5 or 1–10) across various performance dimensions, such as communication, teamwork, punctuality, and job knowledge. It provides a quick and quantifiable way to assess performance, but it can be subjective if not accompanied by specific examples or feedback. To reduce bias and improve accuracy, it's important to provide clear definitions for each rating and train evaluators effectively.
These rating systems can be highly customized by including each of the employee’s responsibilities from their job description, and each of the employee’s annual goals, on the rating sheet. This can be an effective way of rating each employee on very specific behaviors and performance that are directly related to each employee’s role.
Regardless of the type of evaluation used, it involves observing employees’ work, reviewing their progress towards goals, and identifying any areas where they might need additional support or training. Regular check-ins and performance reviews are important for keeping track of employees’ progress and addressing any issues early on. For instance, a manager might schedule monthly meetings with a nurse to discuss their progress towards improving patient satisfaction and provide feedback on their performance.
In addition to providing feedback, managers should offer support and resources to help employees improve their performance.
This might include additional training, mentoring, or access to tools and supplies that can help them succeed.
EXAMPLE
If a nurse is struggling with time management, a manager might provide training on time management techniques or offer a mentorship program with a more experienced nurse.Recognition and rewards are also important aspects of performance management. Recognizing and rewarding employees for their achievements can boost morale and motivation. This might include formal recognition programs, such as employee of the month awards, or informal recognition, such as a simple thank-you note or verbal praise. Staff meetings are great places to recognize good work as well. Praise in front of peers can be powerful. Just be careful that the same one or two employees are not consistently recognized at every staff meeting, while others are ignored. Even a moderate worker is likely doing something that can be recognized, and in doing so, you might notice a burst of production and morale from that employee. Be sure the recognition is evenly disbursed as much as possible. By acknowledging employees’ hard work and contributions, managers can create a positive work environment and encourage continued high performance.
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