Performance management is a nuanced task, often requiring a delicate balance between addressing issues and fostering improvement. In primary care settings, where the challenges are diverse, practice managers play a crucial role in ensuring the team’s optimal functioning. Let’s explore key aspects of performance management with a focus on the unique dynamics of healthcare practice
CREDIT: This is an edited version of an article that originally appeared on Practice Index
Capability vs. conduct
Effectively managing performance hinges on distinguishing between capability and conduct issues. If an employee possesses the necessary skills but seems unwilling to perform, it’s a conduct matter. On the other hand, if the deficiency stems from a lack of training or skills, it falls under performance management.
Consider lateness – a conduct issue if it’s habitual and unrelated to training. However, if an employee struggles due to a lack of understanding or a procedural gap, it becomes a performance matter. Engage in discussions to understand the root cause and proceed accordingly.
Negative influences and assertive team members
Dealing with negative behaviours, such as gossip or a consistently negative attitude, is a conduct issue. For assertive senior team members, however, training might be the key. Frame the conversation around improvement, exploring reasons for the behaviour, offering support, and clarifying expectations.
Transitioning from informal to formal discussions
Moving from informal discussions to formal meetings requires clarity and adherence to the process. Issue a formal invitation in writing, referencing practice policies, and allowing representation. Ensure employees understand the gravity of the situation, maintaining a positive approach aimed at improvement.
Structuring performance management discussions
Approach performance management discussions as opportunities for improvement, not punitive measures. Identify specific issues, seek employee input, and collaboratively devise an action plan. Clearly set expectations, emphasising the desired standard and the consequences if unmet within a defined timeframe.
Managing an aging workforce and mistakes
With retirement no longer an enforceable option, performance management becomes vital for ageing employees. Assess performance objectively, offering support and adjustments as needed. Avoid direct references to age, focusing on the employee’s ability to meet job requirements.
Providing constructive feedback
While giving feedback may seem demoralising, it’s essential for effective management. Emphasise the broader impact on patient care and the duty to utilise public funds judiciously. Persevere, communicate expectations clearly, and foster a two-way effort in professional relationships.
Addressing mental health
Health-related performance issues, whether mental or physical, require a sensitive approach. Engage in early discussions, explore support options, and consider reasonable adjustments. Involve Occupational Health for assessments and follow a fair process, ensuring documentation for evidence.
Managing sick leave
When performance management coincides with sick leave, shift the focus to absence management. Communicate that the process will resume upon their return, reinforcing the goal of improvement. Document expectations, support offered, and potential consequences if performance doesn’t improve.
Handling disagreements during appraisals
Disagreements during appraisals are common but manageable. Utilise pre-appraisal questionnaires to anticipate concerns, providing evidence for performance concerns. Document disagreements, clarify expectations, and offer support, maintaining a focus on improvement.
Overcoming accusations of bullying
Accusations of bullying can be challenging. Reflect on your intentions, seek peer input, and recognise that reactions reflect the individual’s defensiveness. Provide positive feedback regularly and use constructive criticism to foster a culture of improvement.
Setting targets and KPIs
Setting targets in primary care may involve operational challenges, but achievable objectives exist for all roles. Whether framed as targets or appraisal objectives, these can enhance engagement and tie into pay reviews. Exercise caution with attendance as a KPI to avoid unintended consequences.
In the intricate landscape of healthcare practice, performance management demands a holistic approach. By balancing firmness with empathy, fostering improvement, and adhering to best practices, practice managers can navigate the challenges and ensure the optimal functioning of their teams.
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