American Association for Physician Leadership

Operations and Policy

Staff Motivation and Performance Reviews: A New Approach

Ronald S. Hartley

February 8, 2018


Abstract:

Besides doing our taxes, one of the most dreaded annual events is the performance review. It doesn’t matter if you’re the one conducting the review or the one being reviewed, this annual ritual is met with dread, fear, and trepidation. This article explores a new approach to the review that lifts the cloud of negativity. It’s quite possible that you’ve been doing it wrong all along. Not only will we unveil a new approach, you’ll also learn precise steps to follow to make this an enjoyable, worthwhile, and profitable experience. In addition, we’ll look at some of the factors you need to be aware of to encourage and motivate your employees rather than demotivating them. Effective reviews, ongoing encouragement, and timely communication not only will enhance your relationship with your employees but also can help increase overall staff efficiency and ensure that your office runs smoothly.




The story is told of President Kennedy taking a tour of a NASA facility. As he came around a corner he unexpectedly bumped into a janitor who was hard at work mopping the floor. As was his custom, President Kennedy struck up a conversation. “What is it that you do here?” he asked. The janitor’s immediate response was, “I’m helping us put a man on the moon.”

Wouldn’t it be great if every member of your team had a similar vision, and was able to grasp the big picture rather than simply focusing on their individual tasks? It’s the difference between being fully engaged and simply doing a job. Let’s explore how you can develop a team that will help you “put a man on the moon.”

Levels of Employee Engagement

Based on their extensive research, the Gallup organization has categorized employees into three general groups in terms of their level of engagement.(1) This might seem like an oversimplified generalization, but I think it is meaningful and insightful. The three categories are as follows:

  • Engaged: These employees have an extreme connection to their work. In Gallup’s words, they “work with passion and feel a profound connection to their company. They drive innovation and move the organization forward.” Nationally, about one third of all employees fall into this category.

  • Not engaged: These employees are simply putting in time. Gallup describes them as “essentially checked out.” They’re sleepwalking through their workday, putting time—but not energy or passion—into their work. This group represents roughly half of all employees.

  • Disengaged: A descriptive expression sometimes used for this group is “miserable underminers.” Gallup further explains that these employees “aren’t just unhappy at work; they’re busy acting out their unhappiness.” These workers constantly seek to destroy what their engaged coworkers are building. Amazingly, Gallup’s data show that this group represents about 16% of the total workforce.

The goal in any medical practice should be to make sure that all team members are fully engaged and have a passionate connection to furthering the overall objectives of the practice. Not only does this make for a better work environment, but your patients have a sixth sense about who is engaged and who isn’t. It just might make a difference in their decision to stay with you or to go somewhere else for their healthcare needs, and it will certainly make a difference in the quality of the reviews they give you on social media.

Clarity of Team Goals

In order to effectively monitor performance, you need to have benchmarks against which you can measure employee activities. As a start, you need to be clear on what your practice as a whole is trying to accomplish. Are you looking to grow your patient base, are you looking to provide the ultimate patient experience, are timeliness and efficiency at the top or your priority list?

It is important for your expectations to be clear so that your team members can ensure that everything they do is moving you toward your goals.

If you have not determined your priorities and created a mission statement, that is something you should do right away. Write it all down and make sure everyone has the opportunity to review it. If you’re looking for discussion items for your daily or weekly team huddle, this is a good one to put on the list. It is important for your expectations to be clear so that your team members can ensure that everything they do is moving you toward your goals. The janitor in the story cited earlier knew exactly what the ultimate goal was. His contribution—as small as it might have been—was moving the organization closer to the desired result.

Individual Goal Setting

When setting performance goals with individual team members, it is important to seek clarity and consensus. In other words, make sure the goals are clearly understood and that each team member has fully bought in to whatever you decide together. This should not be you telling them what to do, but, rather, both of you coming up with a plan of action that includes benchmarks or goals along the way. For effective goal setting, it helps to follow the SMART principle. All goals should be:

  • Specific: Avoid generalities.

  • Measurable: Put a number to it.

  • Attainable: Can it really be done?

  • Relevant: Does it move both of you closer to your goals?

  • Time bound: Assign start and completion dates.

Avoiding Demotivation

As a team leader, you need to be aware of how you influence the level of engagement in your office, in both a positive and a negative fashion. Sometimes we inadvertently do things that have the opposite effect to what we intended. Your words and actions should motivate and energize your team rather than demotivating them. Here are five things you need to be aware of and avoid:

  • Micromanaging: You hired them because you thought they were qualified; give them the latitude to prove it.

  • Dismissing new ideas: If you want to stifle creativity just say, “That’s not the way we do things here.”

  • Placing blame: Sometimes bad things just happen. Unless it’s a pattern, you don’t always need to find someone to place the blame on.

  • Public shaming: If you need to reproach somebody, do it in private. Embarrassing someone in public is never a good idea.

  • Unrealistic expectations: You probably know what it’s like to face an insurmountable hurdle. Yes, make your employees stretch and grow, but don’t ask them to do the impossible.

By avoiding these behaviors you will remove barriers to success and progress that sometimes keep team members from contributing at their maximum potential. It is important to be aware of how your own words and actions can have either a positive or negative impact on your team.

Monitoring Performance

Whether you’re on the giving end or the receiving end, the annual performance review is rarely an event you look forward to with great anticipation. There are a number of reasons for this, but I think a big part of it is that there’s always a degree of uncertainty, and we have an innate fear of the unknown. If you’re the one being reviewed, you’re nervous about what your supervisor thinks of you and what he or she might bring up that could put you in an unfavorable light. If you’re the one doing the review, you’re nervous about what questions to ask and how to make this a positive experience.

Have you noticed how your anxiety level seems to get higher and higher the closer you get to the dreaded date? That’s probably because no one ever taught you how to do a review. Once you’re given a framework it can actually be a positive experience that you look forward to.

A New Approach

While old-style annual reviews do serve a useful purpose in measuring performance and evaluating eligibility for salary increases, there is another methodology to consider. If you want to monitor performance and provide motivation to do a better job, you might consider doing “quarterly” performance reviews. Now, the first response I typically hear is, “But that’s four times the work!” Well, if done correctly, it’s actually a time saver. Here are some reasons why the quarterly review makes a lot of sense:

  • The annual review typically focuses only on recent activity, good or bad.

  • Issues arise mid-year that are better dealt with immediately.

  • More frequent reviews make it a less stressful and more casual event where it is easier to communicate freely.

Keys to an Effective Review

  • Comfort: It is important to find a comfortable location for the review. This should feel like a peer-to-peer discussion, so sitting somewhere without a desk in between you is a good idea.

  • Privacy: Make sure you are in a location where you won’t be disturbed and where no one can listen in on your conversation. If either one of you is looking over your shoulder it stifles the flow.

  • Openness: It is always good to start the review with a sincere “thanks” statement. What do you thank them for? Well, it might be as simple as thanking them for taking time to meet with you, or you could thank them for their dedication to helping the team reach its goals. This sets the employee at ease and lets them know you’re not simply there to judge them or to focus on the negatives.

  • Specific questions: Rather than just going with the flow, it’s good to have a set of specific questions ready. Remember, you want to find out what the employee is feeling about his or her work experience and how he or she can more fully contribute to your practice’s goals, and how you can help the employee improve as a team member. Even though you are the supervisor, this meeting should not be about you monopolizing the time. Here are six specific questions you can use to generate a meaningful discussion:

    • What is one thing you did recently that you’re most proud of?

    • In what ways do you feel that you’re making personal progress here?

    • What’s the best thing about working in this office?

    • If you were in charge, what’s one thing you’d change?

    • What’s the biggest challenge you’re facing in your job?

    • What’s one thing I could do to help you and the team reach our goals?

  • Listening: These six open-ended questions should generate a fair amount of discussion. Listen without judgment and don’t be afraid of what might come back at you. Remember, you don’t have to resolve all issues in this meeting. Sometimes the best answer is, “Thanks for bringing that up. I’ll give it some thought and get back to you.”

  • Plan of action: I think it’s great to sum up the review with the following two questions:

    • What would you like to be held accountable for when we meet next?

    • What can I be held accountable for when we meet next?

  • Documentation: It’s important to take notes during the meeting without letting it become a distraction. You’ll want to refer back to these notes from time to time as a reminder of follow-up and action items.

Gathering Intel

One other tidbit that will make employee evaluation easier is to make electronic post-appointment surveys available to your patients. There are a number of companies, including the one I work for, who make surveying your patients a snap. These surveys are a great way not only to monitor the patient experience, but also to get valuable feedback on how your employees are doing. I’d recommend including a question like, “Was anyone particularly helpful during your visit today?” or “Could anyone have done a better job during your visit?” If the same names keep popping up for either question, you’ll be alerted that action is required, whether it be praise or correction.

Summary

Try this new review system for at least one round and then make adjustments to fit your specific needs. Used consistently and effectively, quarterly reviews will help you and your team reach the moon.

Reference

  1. Gallup: U.S. employee engagement. Gallup. July 30, 2017. http://news.gallup.com/poll/214961/gallup-employee-engagement.aspx .


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