Performance improvement is the process of measuring the output of a particular process or procedure in an organization and then modifying the process or procedure to increase output, increase efficiency, and/or effectiveness of the process or procedure. Performance improvement in healthcare (discussed extensively here https://www.healthcatalyst.com/insights/implementing-healthcare-performance-improvement-initiatives/) is done routinely in healthcare organizations in order to improve clinical outcomes and patient experiences while reducing costs.
Performance Improvement Plan
Performance improvement initiatives sometimes tend to fail or not produce the desired results when the organization does not have an appropriate plan in place. A performance improvement plan (PIP) also referred to as performance action plan, helps healthcare organizations plan out a performance improvement initiative from start to end ensuring goals are met, tracking milestones and improving on the ongoing process.
There are steps that can be followed to set an effective performance improvement plan. Some of these steps are:
- Document Performance Issues
- Develop an action plan
- Review the performance plan
- Meet with employees
- Follow-up and Feedback
- Performance improvement conclusion
Document Performance Issues
The first step in making a performance improvement plan is documenting the areas of performance that needs improvement. This documentation must be accurate, objective and free from sentiment. The documentation should also be standard and uniform across all employees for transparency purposes and to eliminate any suspicion of bias. The format of a performance improvement plan documentation varies from organization to organization but the standard should include the following components:
- Employee information
- Relevant dates
- Description of performance discrepancy or gap
- Description of expected performance
- Description of actual performance
- Description of consequences
- Plan of action
- Signatures of the manager and the employee
- Evaluation of the plan of action and overall performance improvement plan
Develop an action plan
The next step is developing an action plan which is best done when it’s in collaboration with employees. Having employee input in developing the action plan increases the chances of having a successful action plan. The action plan should be specific, measurable, accurate and time bound (SMART). The action plan should set performance expectations and the consequences of not reaching those goals. Though it is important for a plan to be flexible, it is very important that the consequences of not reaching a goal are not purely on paper. If the plan is not carried out to the tee including punishment for not reaching goals, it will weaken the validity of the plan and undermine the performance improvement process.
Review the performance plan
Before presenting the performance improvement plan to employees, the plan should be properly reviewed by preferably a third party to check for bias, sentiments, and discrepancies.
Meet with employees
Depending on the type of performance plan as well as other factors, the employees should be met one on one in private or in a group. Sometimes both are required for effectiveness.
Follow-up and Feedback
Regular follow-up meetings should be set in other to get feedback from the employer to the employee(top-down) and from the employee to the employer(down-up). During these meetings, the employee can express concerns about the plans, ask for clarifications or further guidance. These follow-up meetings also help ensure the PIP has not lost momentum or direction.
Performance improvement conclusion
This is at the end of the performance improvement initiative. If the employee is unable to meet expectation action has to be taken. This action doesn't always have to be termination or suspension. It could be taking a different approach to help an employee or department. The different actions to take depending on outcomes of performance improvement initiatives should be stated in the plan at the beginning and the plan should consider all possible scenarios.
In conclusion, a performance improvement plan should include:
- Clearly and objectively set out where the employee is failing
- Set out the improvement expected for the employee using measurable objectives
- State whether support or training will be provided
- Provide for the time and frequency of reviews
- Make clear what actions need to be taken for improvement
Performance Improvements Plan and Cost of Healthcare
Part of improving performance in a healthcare organization should also tackle reducing the cost of care. It doesn’t take a newsflash or headline for you to know that the cost of healthcare has gone up. Not only has it gone up year by year, but most in the healthcare industry can’t explain exactly why this is the case. Obviously, there are new machines and technological advances that must be paid for. There are also staffing requirements that may require an increase on the system as a whole, but these don’t explain the almost 25 percent increase in per capita costs between 2007 and 2014. As such, the need to understand and gain more control over healthcare cost accounting, which is an activity-based accounting tool that brings to light how money is being spent in an organization.
We already know that data is being collected each time that we visit a doctor’s office or emergency room. This information is valuable for many reasons beyond reporting to the government or getting reimbursements from insurance companies. In fact, much of the documentation helps to treat you and other patients because we are all quite similar in symptoms and results. However, we have all been reduced to data points and treatment codes rather than actual patients during some point or another in our healthcare histories. A general standard of costs was established somewhere along the way, and everyone agreed to it. It stated that for healthcare treatment “A”, the cost would be the such-and-such amount.