Performance management includes a management structure and a supervisor that is responsible for 1) selecting employees who have the capacity to perform essential job functions; 2) designing jobs, tasks and functions, and work processes to facility and support quality performance; 3) establishing clear expectations; 4) providing orientation, training, and continuing education; 4) removing barriers and provide employee with the tools, resources, and physical environment necessary to achieve the desired results; 5) providing feedback to ensure that employees receive the information necessary to meet and even exceed expectations; 6) planning for consequences of doing a job ‘so that it matters if it is done correctly or incorrectly’; 7) holding employees accountable as necessary; and 8) treating all employees fairly and consistently (TDMHMR, 2000, p. 4).
According to Fried and Fottler in the text book entitled Fundamentals of Human Resources in Healthcare, they explain that ‘the ultimate goal of human resources management (HRM) is to align the work of individuals and teams with the goals of their organization’ (Fried & Fottler, 2011, p. 157). They further explain that performance management is ongoing and includes managerial responsibilities and activities including ‘setting performance goals with employees, monitoring employees’ progress toward their goals, designing strategies with employees to make and sustain improvements, and providing ongoing feedback and coaching’ (Fried & Fottler, 2011, p. 157). This is described by Fried and Fottler as an appraisal (that generally occurs annually) of the employee’s performance that may include discussions about personnel decisions, such as a promotion, change in compensation, disciplinary action, transfer, or recommendations for training (Fried & Fottler, 2011, p. 169).
Fried and Fottler explain that ‘because performance management has historically focused on evaluation or measurement aspects, relatively little attention has been given to its improvement aspects’ (Fried & Fottler, 2011, p. 173). There is also much ‘cynicism’ about performance management, because it is believed that the process can be subjective and punitive, as well as uncomfortable for both the manager and the employee (Fried & Fottler, 2011, pp. 169-170).
To diminish the cynicism and to assure that the performance management interview is successful employees should know what is expected of them on a daily basis. Performance management interviews can also deviate from the traditional annual appraisal varying according to an ’employee’s performance and longevity in the organization’ (Fried & Fottler, 2011, p. 174). This way it is possible to tailor the performance interview to the need of the employee. As Fried and Fottler explain, a high performer may need only an annual interview/appraisal (with ongoing feedback). In these cases the performance appraisal serves to support ht employee and reinforce their current abilities. Performance appraisals for average performing employees verify to the employee that they are completing their work as expected. For those who are marginal or poor performing employees, there may be a need for performance appraisals to be completed more frequently (perhaps even monthly), this way, the manager can keep the employee informed of their unsatisfactory job performance and work with them to coach, mentor, and potentially improve their work performance. In cases where the work performance does not improve, the performance appraisal can serve to help the manager to adequately and effectively provide disciplinary action as needed to the employee (Fried & Fottler, 2011, p. 175).
In any case, it is imperative that the manager/supervisor prepare for the interview and have a clear set of goals. Managers/supervisors should be prepared prior to presenting the performance information. They should not only be prepared with the appraisal itself, but for the reactions of the employee and to refocus the discussion so that the employee can engage in problem solving (Fried & Fottler, 2011, p. 175). In order to demonstrate the appropriate steps for a performance appraisal let’s consider the fictional employee, Joe Cool, as a reference. We will assume that Joe has been employed by a mental health facility as a psychiatric tech for one year. In his job he is responsible for providing direct patient care including emergency, health, and personal care services. He is also responsible for reporting and documenting patient conditions, interacting with patients therapeutically, and participating in the individualized recovery planning (HHS Job Center, n.d.). Joe’s primary responsibilities include maintaining direct and on-going therapeutic interaction with patients, promoting living and social skills, and encouraging progress toward patient goals in a lesser restrictive environment than the hospital (HHS Job Center, n.d.).
Given this, the manager should prepare a performance evaluation that is consistent with Joe’s job expectations. Prior to the appraisal, Joe should have had adequate time to read and review his job description, as well as the criteria for which he will be evaluated during his annual performance appraisal (TDMHMR, 2000). In the case of Joe Cool, the criteria should be chosen from his assigned responsibilities (described above), The performance appraisal will include the following questions: 1) Does the employee (Joe) provide care in accordance with the individualized recovery plan; 2) does the employee complete documentation of patient conditions on time, objectively, and in accordance with agency documentation policies and procedures; 3) Does the employee interact with patients therapeutically; 4) does the employee participate in the individualized recovery plan for those he works with providing clear, objective feedback to the treatment team; and 5) does the employee arrive to work on time and is prepared to for work at the start of the shift? Each of these items is designed to assure that Joe (the employee) is meeting the expectations of his essential job functions. Questions 1, 2, and 5 are designed to look at the delivery of results; questions 3 and 4 are designed to look at communication and teamwork.
Given this, the manager responsible for completing the appraisal is also responsible for assuring that multiple sources of information are used prior to determining the level and/or performance appraisal rating that Joe should receive for his work. This is especially important in cases where the manager did not directly observe the employee (Fried & Fottler, 2011, p. 175). For Joe, the manager should review his work documentation, observe him in the work area and while he participates in a treatment team meeting, talk with members of the treatment team, and review patient satisfaction surveys; this way if there is are question as to why Joe received a particular rating, the manager demonstrate to Joe the specific reason he received a particular rating.
The rating scale uses should include a three point rating system to be used as follows. The rating of 1 will reflect a score indicating that the employee needs improvement in that area; the rating of 2 will reflect a score indicating that the employee meets the expectation of his or her job functions; and the rating of 3 will reflect a score indicating that the employee exceeds the expectation of his or her job functions (TDMHMR, 2000). Using this system will allow for the manager to clearly identify where the employee is at with regard to their work performance and to be rated solidly into one category or another. The manager will assign a rating of 1-3 for each of the questions listed above and will not only review the assigned number but the reasons for each rating and why. This process is explained in detail below.
Once the manager completes the evaluation and is ready to meet with the employee, the manager should secure an appropriate location and bring any relevant and supporting documentation to reference during the interview (Fried & Fottler, 2011, p. 175). For example, if Joe consistently uses abbreviations in when completing his documentation and abbreviations are prohibited by the hospital, it would benefit the manager to bring a few examples of Joe’s documentation to the interview to show Joe where and when he uses the abbreviations. The manager should also bring a copy of the ‘no abbreviations policy’ along to the interview this way the manager can show Joe why he is not allowed to use the abbreviations.
It is also the responsibly of the manager/supervisor to ensure that the employee is adequately prepared for the performance management interview. They should do this by providing their employee with ongoing training and continuing education, feedback and coaching, recognition for good work, information about improvement opportunities, and opportunities to correct problems before they become serious (and/or well in advance of the performance interview) (TDMHMR, 2000, p. 8). The performance interview should also not be the first time that an employee first hears of a concern, as ‘there should be no surprises during this discussion’ (Fried & Fottler, 2011, p. 173). It is better for ‘critical information’ about the employee’s performance to ‘have been communicated earlier, closer to the time the particular performance issue happened’ (Fried & Fottler, 2011, p. 173). As explained earlier, this way the employee has time to correct the behavior without significant consequence (especially one tied to compensation).
Fried and Fottler explain that ‘a key step in the improvement process is to provide performance information to the employee’ (Fried & Fottler, 2011, p. 173). The performance interview/appraisal a way to do so and should be ‘a time to reflect on past performance and plan for the future’ (Fried & Fottler, 2011, p. 173). The first step in the interview is for the manager to recognize the employee’s current efforts acknowledging 1) a substantial improvement in performance, 2) satisfactory performance over an extended period of time, and/or 3) performance above and beyond that which is normally expected (TDMHMR, 2000, p. 3). This way the employee is assured that their manager and/or supervisor is aware of and supports their efforts, and that the interview is based on credible, consistent, individualized, and proportionate information (TDMHMR, 2000, p. 8).
The recognition should be described by the manager in a specific manner using specific characteristics of the employee’s performance. The manager should also explain how the performance helps the employee, the people served by the organization, as well as the other staff in the organization. Finally, the manager should thank the employee for his or her contribution encouraging them to continue (TDMHHMR, 2000, p. 9). In the case of Joe, the manager should not bring up the issues with Joe’s documentation as the first agenda item. Instead, the manager should find something that Joe does well. For example, if Joe is very good at his therapeutic interaction with the patients, the manager should lead the conversation with something such as: Joe, I just want to say that you do an amazing job with the patients. They are always mentioning how you encourage them to follow their plans and that they can really talk to you. Thanks for your hard work. I know that it really makes a positive impact on the patients, and it shows us what you do really matters to our hospital.
The next step in the performance interview is where the supervisor/manager ‘can discuss problems and suggest solutions’ for their employee (Fried & Fottler, 2001, p. 173). It is important for the manager to assume a coaching role during this discussion, as the goal is for the employee to improve their performance. During this time, it is important for the manager/supervisor to describe the task/issue very specifically explaining the importance of the task. Next the manager/supervisor should explain why the task should be completed, and the standard used to evaluate the correct performance of the task. The manager must ensure that any discussion remain on employee behavior (i.e., job performance) and results and not on personal traits (Fried & Fottler, 2011, p. 175). In the case of Joe, this is where the manager can discuss the issues with Joe’s documentation. The conversation should remain on the facts. The manager should start with the things that Joe does right, such as: Joe, your documentation is always very thorough and you always complete it on time. There is one thing that you can improve and that is your documentation. The manager can then explain: I am sure that this is no surprise to you, as we have discussed this several times this year. I am confident you can improve your work. Let’s together go over the policy and then take a look at your documentation.
If possible, the manager/supervisor should demonstrate the task. If it is not the appropriate time or place for a demonstration, the manager/supervisor schedule a time to demonstrate the task to the employee in an environment where the employee will be able to practice the task in the presence (or review) of the manager/supervisor (where the manager will be able to provide constructive feedback and encouragement until the task is completed correctly) (TDMHMR, 2000, p. 9). In this case, the manager could choose a note that Joe wrote using abbreviations and then demonstrate for Joe how it should be written in the future. It is important for the manager/supervisor to ensure that the focus of the discussion (although it may pertain to previous performance) should be on the future performance of the employee (seeking ways to move forward) this way any current issues can be resolved preventing any future problems (Fried & Fottler, 2011, p. 175).
The third step during the performance interview is goal setting. Fried and Fottler explain that goal setting is ‘critical to achieving performance improvement and ‘many managers use the SMART acronym as a guide’ to assure that goals are Specific, Measurable, Achievable, Relevant, and Time-bound (SMART). Goals are designed to help the employee to become successful and to assist the employee and the manger to effectively resolve any performance issues, and/or to become better employees. If there is a performance management issue with an employee, it is important that the goal address the issue in a way that sets a very clear expectation (NMSPO, 2010, p. 74). For example, if Joe’s manager wants to write a goal that addresses Joe’s use of abbreviations, the issue may be transitioned into a goal saying: By the end of the quarter, Joe will not use abbreviations more than once per patient assigned to work with him. This way, it is clear to Joe what is expected and when it will be reviewed again. The goal also allows for Joe to have room for error within a three month period. Doing so will allow Joe some flexibility while still improving his work performance, making the goal more realistic to Joe.
For employees who do not have a performance issue, it is still important for the manager/supervisor to use the SMART method/acronym. In these cases, goals can be set by the employee and manager that help the employee exceed expectations or that help them to further their job and career development. In either case, setting approximately three goals (two chosen with the guidance of the manager/supervisor and one by the employee) are very manageable for both the employee and the supervisor to work towards throughout the year (TDMHMR, 2000, p. 74).
It is imperative that throughout the interview the manager encourages employee participation, possibly through an employee ‘self-appraisal’ as the employee ‘may have greater insight’ into his or her own performance concerns (Fried and Fottler, 2011, p 175). In Joe’s case (especially if the manager has had multiple conversations with him without a change in behavior), the manager can ask Joe, for some insight as to why he uses the abbreviations and what he believes will help to correct this issue. Perhaps, Joe is insecure about his spelling and could benefit from some training on use of the spell check function on the computer. Finally, the manager must plan for follow-up activities and pay attention to expectations and timelines (Fried & Fottler, 2011, p. 175). Doing so will validate the interview and performance management process demonstrating to the employee investment the manager/supervisor has in their success (TDMHMR, 2000).
A successful performance management interview is one that is purposeful and meaningful to the employee. The purpose of a successful performance management interview is to provide mangers, supervisors, and employees with the tools to ‘build superior performance’ by identifying employee expectations, addressing performance concerns, encouraging the employee and fostering the development of the employee so they will succeed in the organization (TDMHMR, 2000, pp 2-3). The appraisal process starts upon hire of the employee, as the employee should be aware of all that is expected of them once they have completed new employee orientation. It is the responsibility of the manager to coach, mentor, guide and correct the employee throughout the appraisal period. They must also make the employee aware of the criterion for which they will be rated (TDMHMR, 2000). Additionally, the manager must reinforce the positive performance of the employee (not only formally at the beginning of the interview), but throughout the interview to ‘ensure that the interview focuses on all aspects of performance, not just the negative. Doing so will validate the appraisal and help to remove any associated cynicism with the appraisal process (Fried and Fottler, 2011).
With evaluating employee performance, there comes a great responsibility from the manager. To adhere to this responsibility, the manager and/or supervisor must ‘provide employees with feedback on their performance continually’ (Fried & Fottler, 2001, p. 169). The manager should never end an appraisal without asking the employee if they have any questions about a particular task, the criterion, or the level of performance expected. The manager should always reiterate their continued support for the employee and ways to ask any additional questions that may arise; expressing confidence in the employee and reminding them that they will improve their performance of the task. The manager is expected to follow-up with the employee to ‘ensure mastery of the task’ (TDMHMR, 2000, p. 9).
Fried, B.J., Fottler, M.D. (2011). Fundamentals of human resources in healthcare. Health
Administration Press. Pp. 155-179.
Health and Human Services Job Center. (n.d.) Psychiatric nursing assistant. Retrived from
Texas Department of Mental Health and Mental Retardation (TDMHMR). (2000). Positive
Performance Program Participant Manual. Human Resource Development. Internal Facilities Management. Pp. 1-33.
New Mexico State Personnel Office (NMSPO). (2010). Performance Appraisals and
Management. Operational Instructions. Pp. 3-82.