June 2018

OPHTHALMOLOGY BUSINESS

To the point: Simple practice tune-ups for complex times
Adding value to your employee performance appraisals


by Corinne Wohl, MHSA, COE, and John B. Pinto

“When you can’t see someone all day long, the only thing you have to evaluate is the work. A lot of the petty evaluation stats just melt away.”
—Jason Fried

“When we make progress and get better at something, it is inherently motivating. In order for people to make progress, they have to get feedback and information on how they’re doing.”
—Dan Pink

For those of us who are old enough, we remember a time when managers and employees could look forward to “evaluation and raise time.” This was before reimbursements shrank, profit margins tapered. It was a time when salary increases were generous and the performance appraisal process was less precise and less diligent.
Fast forward to our leaner times and the challenges of encouraging employees to be increasingly productive with fewer monetary rewards, and you must find additional ways to retain the best employees. One chief contributor to employee retention is to set clear expectations for job performance up front, and subsequently provide the feedback necessary to recognize achievement or skills gaps.
How can you accomplish this in your practice? Thought-provoking, meticulously detailed, goal-oriented performance appraisals will add value to your practice. Staff productivity and job satisfaction can be improved when each employee has access to and understands the expectations you have for them and how their personal success helps the practice flourish.
Perfunctory performance appraisals are boring and unsatisfying for your managers and employees. “Appraisal lite” can be viewed as a discouraging waste of time and disappointing for those best staff who are looking for feedback that helps them grow professionally.
If your performance appraisal process tends to generate a lackluster response, with the exception of “And now do I get a raise?” you have room for improvement.
Here are nine ways that your management team can tune up the evaluation process.
1. Tailor your performance evaluation forms to corroborate with each position description. This helps to focus employees on what you are specifically prioritizing within their job duties. By clearly listing how you will rate their duties and functions, they are prepared in advance for the skills the practice will be evaluating.
2. Effective evaluations include both objective and subjective components. The objective components must be measurable to clearly communicate the current status and improvement goals. An example would be, “Be able to accurately work up a routine patient in 20 minutes or less.” Subjective measures allow you to acknowledge enthusiasm, effort, insight, and allow for discretionary feedback. An example would be, “Patients should report that you answered their questions in a friendly and informative manner.”
3. Set three specific goals for each employee, listing the highest of priorities. Include examples of what it will take to achieve each one. For example, rather than stating “We need you to be a better biller,” say, “You are currently posting 100 charges daily. Your goal, to be accomplished by September 30, is to be posting 150 charges daily.”
4. Avoid these common weaknesses found in personnel evaluations:
a. A manager scores everyone exceptionally high, in comparison to their management team peers. This scoring method, while it makes staff happy, will limit you in future years regarding each employee having appropriate goals to reach.
b. The written details do not include the “what and how” to improve the weaknesses listed. 
c. Specific feedback is not provided, particularly if there were previous issues addressed. If you do not know the details, discuss with the employee directly and complete the form.
d. Goals or opportunities for improvement are not included. Even the best employees can improve something they already do well. It’s OK for goals to include going from good to great.
5. Inexperienced managers and managers who have been poorly supervised can be understandably wary of evaluations. With such staff, explain in advance of the review session why your practice performs reviews and that they are not a “gotcha” session, but a formal opportunity for two-way improvement.
6. If everything is a priority, then nothing is prioritized. Establishing communication and goal-setting requirements via the evaluation process helps keep managers and staff aligned with chief practice goals. This is especially important in fast-growing practices where organizational priorities can shift from month to month.
7. Consistent evaluation scoring across the practice can be a challenge. Some managers grade easy and others grade hard. Management philosophies differ for motivating staff, ranging from giving high praise to leaving scoring room for challenges and growth. Work with your management team to set the parameters you want followed for your practice.
8. Determine your reward system for the accomplishments achieved and to be recognized. Set a budget for salary increases (or bonus ranges) that your management team will work within. Develop standards with your managers for fair distributions. Not all rewards need to be salary-related. Alternate rewards include time off with pay, gift cards, one-time bonuses, and public recognition for excellent achievement.
9. Schedule performance appraisals to be completed by the management team throughout the year. Use the hire date (which becomes the employment anniversary date) as the annual evaluation date for each employee. This spreads the task out over the year for managers. It also takes the focus off “raise time” in the practice. Practices that complete all staff evaluations at the same time annually face challenges in keeping salary comparisons among the staff limited.
Apply this focused, specific, goal-setting communication to all other facets of your practice, to providers, even vendors. Highly successful practices have learned to clearly communicate measurable goals and expectations throughout the organization and provide actionable, encouraging feedback on the progress being made.

About the authors


Ms. Wohl is president of C. Wohl & Associates Inc., a practice management consulting firm. She earned her Masters of Health Services Administration degree at George Washington University and has more than 30 years of hospital and physician practice management expertise. She can be contacted at czwohl@gmail.com or 609-410-2932.  

Mr. Pinto is president of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm in San Diego. His latest ASCRS•ASOA book, Simple: The Inner Game of Ophthalmic Practice Success, is available at www.asoa.org. He can be contacted at pintoinc@aol.com or 619-223-2233.

Adding value to your employee performance appraisals Adding value to your employee performance appraisals
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