Managing Your Team’s Weakest Link

Most healthcare executives know what to do when a member of the team demonstrates consistent unacceptable performance and everyone knows it, including that employee. It’s relatively straightforward to let such a person go, especially when the employee has had ample support, opportunity, and documented warnings to improve, but hasn’t.

However, some situations will test your patience, heart, and skills. For example, imagine that a low-performing employee is an individual whose performance in the past was acceptable or even better than acceptable. Now, unfortunately, his performance has declined sharply, making him the poorest performer on your team. This sometimes occurs when the organization undergoes big changes. Some employees have trouble adopting new values, skills, relationships, leadership, systems, and ways of thinking. A decline in performance can also occur when an employee experiences dramatic personal change — for example, when he or she is challenged by loss, illness, addiction, caretaking responsibilities, financial stress, marital discord, separation, or divorce. Even positive changes can lead to a decline in an employee’s performance. Having a side business take off, studying for final exams, becoming passionate about hobbies or causes, falling in love, planning a wedding, becoming a new parent, or receiving a sudden influx of money through inheritance or winnings can provide powerful distractions that interfere with an employee’s work quality and effort.

Now imagine an even more challenging problem. Suppose that you are managing an employee who is good but not good enough to help your team or your organization reach the future it envisions and wants. This can happen when longtime employees whose performance has been adequate so far will not do or give enough to help the team grow and attain increasingly more ambitious goals. The level of performance that was at one time good enough may not be good enough anymore. Or perhaps the employee’s skill set was sufficient for the healthcare organization of your past, but not of your future. Perhaps you would not entertain the idea of hiring this individual now, but he or she was hired long ago, when things were different.

In both of these situations, your first thought may be to keep your lowest-performing employee but to find other work for him or her to do within your organization, work that requires less effort or that is a better fit to his or her more limited skills. But when that won’t work (and it won’t in many situations), you may feel that you have no choice but to put up with the lackluster performance or to begin the mandatory verbal and written warnings and, ultimately, let such employees go. Certainly, laying a foundation of careful documentation is important, no matter which action you decide to take, but as you document, consider whether the situation is salvageable. What else other than warnings and termination might you try to get better performance out of the weakest link on your organization’s team?

HOW MUCH DOES YOUR WEAKEST LINK COST YOU?

If you are thinking of putting up with your weakest link, think again. A weak employee costs a great deal of time and money for your healthcare organization. Sullivan(1) suggests a simple way to calculate the cost each year:

• Minimum weak employee performance: As much as .75% of the employee’s annual salary.

• Typical weak employee performance: As much as 2.25 times the employee’s annual salary.

• Exceptionally weak employee: As much as 6.75 times the employee’s annual salary. More if the employee makes a costly, catastrophic mistake.

Sullivan suggests that a more sophisticated calculation will include additional cost factors that are harder to quantify. Sullivan explains, “Weak employees can cost more because they make serious errors (that average or top performers don’t). These additional costs are always estimates,” but are nonetheless important. Specifically, Sullivan suggests that additional cost factors include absenteeism, lost revenue, damaging interactions with customers and other stakeholders, errors, accidents, theft, reveal of trade secrets, negative impact on the team, and wasting the manager’s time. Sullivan suggests that you add these estimated costs to your “revenue-per-weak-employee” calculation to understand more precisely what your weakest link costs you. Look at the bigger picture. What will it cost you if you allow your weakest employees to remain in your organization? Sullivan warns, “Because weak performers won’t easily be able to find another job, they may stay forever at your firm, multiplying the damage they are doing over decades.”

WHAT’S THE REASON BEHIND THE POOR PERFORMANCE?

Once you have calculated the cost of your weakest link, an excellent next step is to determine the cause of the employee’s unacceptable performance. We tend to assume that responsibility for poor employee performance rests with the individual, and often it does. A closed-door, no-blame conversation with the employee may get the employee to open up and tell you if the problem lies within him or her and if so, what it is. Keep in mind, however, that there are other possible reasons. For example:

• Problems with the job: Some jobs are poorly designed failure traps; no one is likely to succeed in them. Are your job descriptions and expectations reasonable and clear? Would a good employee be able to do the job well? Has the employee received adequate training? Does the employee have the support and time needed to complete assigned tasks?

• Problems with your healthcare organization: An employee’s performance can slip if he feels that the workplace is unsafe or unethical, that he has been shunned by the other employees, or that he is the target of racism, sexism, bullying, or harassment. Has the employee mentioned a problem with your policies or practices? Does the employee feel that he fits in socially with the rest of your team? Has another employee or patient said or done anything that has hurt or disrespected the employee? Kolditz(2) suggests that uncovering problems such as these is a “gift.” Kolditz explains,” In the long run, it’s usually more important for you to address those conditions than it is to fret over a single weak employee.”

• Problems with leadership: Does the employee have a problem with you or with your management style, or with another leader in your organization? Adonis(3) claims that organizations that are plagued with poor-performing employees need to have their leadership take a look in the mirror. Is your weakest staff member a singular case or a part of a larger pattern of underachieving employees? In some cases, Adonis suggests, poor performance points to a larger motivational issue, which is something mostly influenced by a supervisor’s behavior and attitude.

• Problems with communication: Does the employee know what was expected of him? Ask the employee to articulate job expectations in his own words. If he can’t do this well, try to figure out whether the problem is with the employee or with the way that you or someone else in your organization has articulated your expectations. Adonis says, “Employees who have clarity on what they’re supposed to achieve are more likely to achieve it.”

• Problems with the fit: Consider the fit between the job and the individual. Does the job fit the employee’s strengths? Does it call upon her to perform activities that she doesn’t like or doesn’t value or that she fears or finds objectionable? Do the assigned duties require the employee to perform in ways that are contrary to her beliefs or culture? Does the employee want to work with the patients you serve?

It is often difficult for employees to tell their managers about problems with the organization or within themselves. That’s why it is essential to keep the tone of your conversation supportive and constructive. If you determine that the problem is not the employee, take steps to rectify the situation. For example, redesign the job so it is more reasonable. Be clearer about the job duties and your performance expectations. Take immediate control of any situation that you deem to be unsafe or unethical. Move the employee to a position that makes better use of his skills and interests, or counsel and encourage him to seek another type of employment that would be a better fit. And of course, take decisive, immediate action to verify and stop any bullying behaviors or harassment that you uncover.

HOW HAVE YOU COMMUNICATED YOUR CONCERNS?

Once you’ve determined that the problem is with the individual and not with something or someone else, find out if the employee knows that there is a problem. This should happen sooner rather than later. Hill and Lineback(4) comment that you do not want to tell an employee that he is in trouble only after you’ve concluded that you’re going to terminate him.

Of course, you will want to give both verbal and written warnings as needed, but don’t rely solely on these one-way forms of communication. Ask the employee to tell you in his own words what the problems are, what he needs to do about them, and by when. If you’ve described the possibility of termination or another consequence, ask the employee to repeat back to you what will happen to him if performance doesn’t improve as indicated, and when that will happen.

It is important to hear all of this from the employee to be sure that he fully understands the problem, the actions he must take, and the consequences. If you do all the talking and the employee simply says I understand or signs a written warning, you won’t know for certain that he truly understood you. Many things can interfere with comprehension, such as being upset or ill, not believing that you mean what you say, or being distracted. When you hear your message repeated back to you in the employee’s own words, you will have a way to gauge how well that message has gotten through.

HANDLING RESISTANCE FROM YOUR WEAKEST LINK

Low-performing employees may dig in their heels when you bring the problem to their attention. They may resist what you are saying, pointing to a previous manager or leader in your organization who did not feel as you do. For example, you may hear something like, “I’ve worked here for six years and I’ve never heard this before.” Or you may hear, “The last two administrators never told me these things were expected of me (or that there was a problem with the way I do things). Why is this coming up now?”

It may be that expectations for employee performance have changed in your organization, or perhaps this employee was undermanaged. Either way, here is a way that you can respond to such resistance: “I hear what you’re saying. And while I cannot speak for previous managers, I am very open about giving feedback and setting clear expectations. If I am not establishing and communicating clear expectations, then I am not doing my job. Plus, the last thing I want to do is wait until our performance review time to bring this up. I would rather have the conversation now. The expectations for your position that I have outlined are important and essential for any person in this role. My sense is that these are things you are capable of doing. What do you think?”

FOCUS ON THE TEAM

At this point, you may be tempted to focus your effort on fixing your weakest link. In fact, you may feel pressure to do so from other team members who resent the poor performer. In response, you may start to squander your time and energy in what Kolditz calls “righteous indignation, remediation, and repair.” You may convince yourself that if only you could fix this one person, your entire healthcare organization would be better. Be very careful, Kolditz warns. You may end up spending a disproportionate amount of your time on your weakest link. If your worst employee is taking attention and energy away from the best employees in your organization, Kolditz states, there is no way that you are performing to your own capacity. He describes such leadership as “distracted and ineffectual.”

Rather than spending a great deal of your time and effort trying to fix your weakest link, point to the weak performance as team indicators rather than individual failings. Identify vulnerabilities in your organization and areas where you can make changes to strengthen your processes. Encourage your team members to take responsibility for the work they produce collaboratively. Teach them to critique one another constructively. Remember that the poor performance occurred because there were conditions in your organization that allowed it to occur.

Focus on developing your team overall so that your weakest link doesn’t bring down its performance. Continue to be mindful of where you are spending your time and energy. Kolditz suggests, “A single poor performer can capture a leader’s attention and energy like a drowning person hand, always succeed.”

In some instances, managing the weakest link in your healthcare organization can lead to positive outcomes. You may uncover problems you did not know about that you can correct or resolve. The individual may rise to the occasion and improve his or her performance, or your team may come together and be strengthened by the challenge. But of course, when things don’t improve, or when they worsen, you will need to give the requisite warnings and terminate the employee. If you must take this action, you will know that you did everything you could to turn the situation around. This will help you feel good about your decision but also protect you, should there ever be a question raised about wrongful discharge. For these reasons, document every step you take to manage your weakest link, and when necessary, invite a reliable witness to your conversations.

Excerpted from The Problem Employee: How to Manage the Employees No One Wants to Manage (American Association for Physician Leadership, 2021).

BONUS FEATURE

WHY IS YOUR WEAKEST LINK SO WEAK?

Once you have determined that your weakest link’s poor performance is being caused by something within him (and not within your organization), see if you can pinpoint the reason. For example, the employee may:

• Have no idea of what is expected of him.

• Lack training, skills, and/or knowledge, rendering him unable to perform the required tasks.

• Be dealing with his own or someone else’s illness or addiction.

• Have a learning disability that makes it hard for him to learn new skills.

• Be experiencing a problem at home or at work that is a distraction, preventing him from doing the job well.

• Be experiencing something positive outside of work that is a distraction.

• Be a bad fit to the job.

• Be a poor performer in everything he does.

• Lack integrity.

• Lack an appropriate work ethic.

• Not realize or care that his performance is poor.

• Have a personal agenda that is inconsistent with excellent performance (such as being right, being liked, slacking, getting attention, or hiding something about himself).

Getting weak employees to discuss their problems with you requires trust. Some may truly be clueless. Some will be better at masking their problems than others, and some will say just about anything to hang onto their jobs. A one-on-one conversation behind closed doors will be your best strategy. Explain what you have observed and pay close attention to what the employee tells you. Also notice his or her body language and whether he seems nervous, frightened, uncaring, angry, or dishonest.

One of the best strategies for getting the employee to open up to you is to ask powerful questions. For example, you might ask the employee:

• What is it you are trying to produce/accomplish in your job?

• What is your role on our team? With the doctor? With our patients?

• Is there training that you need to make it easier to do your job?

• Do you have a personal problem that is consuming your attention?

• Is something distracting you from your work?

• Do you like what you are doing?

• What changes would have to take place for you to do better in your job?

• Why do you think your performance has declined?

• What do you think is the problem with you doing things the way you’ve been doing them?

Give the employee time to answer. Do not accept “I don’t know” as an answer. Rather, ask the employee to take more time to think about your question, then ask your question again. Recognize that some problems will be beyond your scope. For example, it is very unlikely that you will succeed in turning around a slacker or an employee who lacks integrity. Personal problems may require help you cannot provide. If you determine that the problem is a serious illness, financial strain, addiction, abuse, or a similar problem, refer your weakest link to appropriate resources as needed.

References

1. Sullivan J. Calculating the dollar cost of a bad or weak-performing employee. ERE, January 6, 2014. www.ere.net/2014/01/06/calculating-the-dollar-costs-of-a-bad-or-weak-performing-employee/ .

2. Kolditz TA. How to turn your worst employee into a top asset. Inc., March 26, 2012. www.inc.com/tom-kolditz/why-your-worst-performer-is-a-gift.html .

3. Adonis J. The weakest link: managing underperforming staff. The Sydney Morning Herald, May 6, 2011. www.smh.com.au/small-business/blogs/work-in-progress/the-weakest-link-managing-underperforming-staff-20110506-1eakw.html .

4. Hill LA, Lineback K. Management skills: How to deal with poor employee performance. Monster, 2014. https://hiring.monster.com/hr/hr-best-practices/workforce-management/employee-performance-management/employee-performanceissues.aspx .