BSM Connection elearning Course

BSM Connection elearning Course Job Descriptions and Performance Evaluations 2008, BSM Consulting All Rights Reserved.

Table of Contents OVERVIEW...1 JOB DESCRIPTIONS...1 SAMPLE JOB DESCRIPTION...3 PERFORMANCE REVIEW...5 METHODS OF REVIEW...6 Sample - Method 1: Ratings-Based Performance Review Form...6 Sample - Method 2: Discussion-Based Performance Review Form...9 CONCLUSION...14 COURSE EXAMINATION...15 2008, BSM Consulting

OVERVIEW Job descriptions form the foundation of the practice staffing structure and provide concise organization of duties and responsibilities within the practice. Position descriptions also form the basis for a rational evaluation of staff performance. This module has been designed to explain the essential elements for writing effective job descriptions and how to use the descriptions as part of the employee performance evaluation process. Instruction regarding methods for employee review and the performance review process are also provided in this module. JOB DESCRIPTIONS Job descriptions are intended to summarize the key characteristics of each position in the practice, providing employees a clear understanding of the qualifications and responsibilities pertaining to the job and forming the foundation for employee priorities and efforts. For management, the description offers an objective means for measuring the qualifications of candidates and performance of incumbents, and for maintaining efficient interrelationships from one job to another. Job descriptions are a critical component of a well-run physician practice. Although the format of job descriptions will vary somewhat from one practice to another, each description should answer several key questions: What is the job title? The title should be succinct and provide an intuitive description of the position without resorting to pretentious or flowery alternatives. For example, the nature of a Switchboard Operator position will be more easily understood than a job titled Communications Support Specialist. To whom does the person in this job report? The lines of authority should be clear and consistent. The job description should identify the person responsible for supervision and evaluation of the individual s job performance. In turn, this description must be consistent with the practice organizational chart. What is the essential nature of the job? The job description should include a one-sentence summary capturing the essence of what the job is about. This summary should be consistent with more detailed information found in other sections of the job description. This section can be very useful for preparation of classified advertisements when vacancy occurs. What education and experience are required to perform the job? This part of the job description should outline the preparation needed to properly perform the job. In many cases, education and experience will be divided between required background (the minimum level necessary) and desired background (the ideal level to ensure job success). This section is helpful when judging applicants for a vacant position. What skills and abilities are necessary for success in the job? This aspect outlines the specific abilities required for success in the position, incorporating a combination of personality, training, and experience into a complete skill set. Education and experience are insufficient if not accompanied by a competent skill level, i.e., a degree in communications does not necessarily make the individual competent in communicating with others. A personality profile (analytical, expressive, driver, amiable, or some variation of these four foundational preferences) will help match job preference to the job requirement. For example, detail-oriented is a skill well suited to a biller; outgoing personality is required for a front desk or 2008, BSM Consulting 1

check-out person. Other examples include: meticulous medical assistant; expressive sales or management; math competency bookkeeper; sense of humor customer service. This section of the job description can help in the employment interview process and in evaluation of employee competency and suitability for the position. What specific responsibilities are included in the job? The description should clearly outline the areas for which the employee assumes responsibility. This forms the basis for evaluation of job performance, testing employee competency in each area with the standards outlined within the job description. These responsibilities should be consistent with the organizational chart and fit logically with the skills and background required of the individual. Ideally, the responsibilities should be measurable where possible, providing a somewhat objective means for assessment of performance. What is the nature of compensation associated with the job? This closing part of the description should describe whether the position is full-time or part-time, the basis for determining compensation, and the benefits package included. The actual compensation amount need not be specified but a range or the compensation level (if standardized levels are used in the practice) should be noted. The length and detail of each job description will vary, depending on the characteristics and complexity of the position. Once finalized, the job descriptions should be kept on file for reference by practice management as needed. Each employee also should maintain a copy for reference. The practice should periodically review job descriptions with staff members to ensure accuracy and update responsibilities, as necessary. A sample job description is provided on the next page for the position of secretary in a physician practice. While the descriptions for many jobs in a typical practice may be less extensive, the sample provides a helpful view of these various elements described and the organization of a typical job description. 2008, BSM Consulting 2

SAMPLE JOB DESCRIPTION POSITION: REPORTS TO: JOB SUMMARY: Secretary Medical Director This position works in concert with the physician director in overseeing administrative, financial, and developmental activities of Best Medical Group, P.C., and its affiliated entities. EDUCATION AND EXPERIENCE: 1. B. Sc. or B.A. degree. 2. At least seven years of medical practice experience, preferably within a cosmetic or plastic surgery practice. 3. Strong financial background with previous accounting or general ledger experience. 4. Experience in medical services marketing. 5. Experience in practice development and expansion, preferably including cosmetic surgery, retail sales, and spa services. 6. Experience in maintaining professional relationships with referral sources, hospitals, and other groups. 7. General management expertise. ESSENTIAL SKILLS AND ABILITIES: 1. Superior interpersonal and communications skills. 2. Decisive leadership with above-average judgment. 3. Trustworthiness. 4. Able to effectively sustain multiple simultaneous tasks. 5. Attentive to detail and accuracy. RESPONSIBILITIES: 1. Practice Development: Identifies opportunities for practice growth and revenue diversification through satellite offices, spa and retail services, or other ventures and ensures effective implementation and subsequent management of designated priorities. 2. Business Planning: Monitors developments in the local market and provides recommendations regarding appropriate responses and strategies, and ensures implementation of planning initiatives. 3. Coordination of Marketing: Develops and administers ongoing marketing efforts to inform current and potential patients regarding practice services available; also monitors effectiveness of such efforts through appropriate measures and review. 4. Financial Operations: Maintains appropriate oversight of practice financial operations including billing, disbursements, reporting, budgeting, and safekeeping of practice assets, and ensures optimal efficiency and profitability within the practice. 2008, BSM Consulting 3

5. Service Standards: Ensures appropriate quality standards in all aspects of practice services provided to patients and maintains effective methods for assessing such performance. 6. Practice Liaison: Acts as a liaison for the practice in coordinating and facilitating its dealings with solicitors, accountants, consultants, and others. 7. Personnel Management: Ensures effective supervision and training of practice staff, encourages optimal performance, and maintains compliance with operating procedures and government regulations. 8. Referral Relations: Maintains positive and loyal relationships among referring specialists, actively solicits and resolves areas of concern, and provides appropriate training and coordinates assistance for referring offices. 9. Other Duties: Performs other duties and assumes various responsibilities as determined by the physician director. COMPENSATION: Comprises a combination of base salary plus performance-based incentives. Benefits as per those provided all full-time employees. 2008, BSM Consulting 4

PERFORMANCE REVIEW Ideally, the job descriptions will form the basis for evaluation of staff performance, comparing each staff member s competency with the responsibilities outlined in their job descriptions. The viability of effective performance review relies on answering two key questions: Does the employee truly have control over the area of responsibility? If the individual has responsibility without authority or the ability to actually control the area assigned, performance cannot be improved and morale will suffer. It makes little sense for a medical assistant to be judged on whether the patient schedule remains on time each day if delays are actually created by the physician or appointment scheduler. Can performance within the area of responsibility be measured? Too many evaluations are based on subjective assessments without the support of valid measurements, creating tremendous morale problems when the evaluation differs from the perception of the employee. If the secretary is to be judged on the basis of maintaining staff morale, the practice should be prepared to routinely measure morale objectively through staff surveys, not based on subjective impressions. Evaluations are vital to employee satisfaction and maintaining staff morale. If a particular date is set for such review, the practice must ensure that the schedule is carried out to maintain credibility for the review structure. While many practices perform annual reviews, the performance feedback can be less than timely and lead staff members to expect wage adjustments whenever such reviews are offered. The object of reviews is to maintain and improve performance, not simply to justify changes in compensation. Feedback should be specific and the message to staff members should be clear. Negative feedback is a frequent challenge for managers, many of whom fear the employee will react negatively toward the job, the practice, or the manager. In addition, human nature often causes people to avoid confrontation. If negative feedback is required by the situation, management must be strong enough to deliver the message effectively, ensuring the employee understands critical issues while not losing the message within the means of delivery. Feedback also should be balanced between positive and negative. Unfortunately, many reviews focus too greatly on the concerns, often leaving employees confused as to the relative weight of things being done well and things needing improvement. Management should strive for an appropriate balance, consistent with the nature of the job done by the individual. The employee should leave the review meeting with a feeling of inspiration to perform to their highest potential. When improvement is needed, follow-up should be scheduled regularly to measure progress until satisfactory performance has been achieved. This may involve monthly or bimonthly meetings following the review. If additional training or support of the individual is needed, management should ensure that such resources are available. Management should be dedicated to ensuring the review process is fair to all employees and applied equitably to all. This means using the same evaluation methods, same bases for compensation adjustments, same frequency of review, etc. Just as importantly, management must be exemplary in its performance, attitude, and job skills, providing a vision of achievement for others in the practice to emulate. Ideally, employees whose performance needs improvement will leave the review meeting inspired to improve, with a clear understanding of what needs to change and the resources needed to achieve such change. Effective management support will play a vital role in the success of this effort. 2008, BSM Consulting 5

METHODS OF REVIEW A number of approaches are available for performance review. Some seek to measure performance objectively using a numerical scoring system, others focus on personal traits related to job performance, and some use a discussion-based approach providing an opportunity to discuss strengths and opportunities with the employee in lieu of focusing on a rating number. In this module we provide examples of two evaluation formats. Method 1 provides an example of a ratings-based review, and Method 2 illustrates the discussion-based review format. Regardless of the format utilized, be specific during the review process, encourage open dialogue, listen, and observe. Consistently maintain notes in a personnel file for the evaluation meetings and obtain feedback from others, if applicable, to assist in a well-rounded evaluation. Method 1: Ratings-Based Performance Review This method applies a weighting to each evaluative component, with the sum of components within each section equaling a value of 1.00. Such weighting is subjective and should be determined separately for each position. During the performance review process, a rating must be assigned for each component based on the reviewer s assessment of performance during the term in question. This rating should be based on a rating scale that is used consistently in all employee evaluations, i.e., a scale of 1 to 5, with 5 being the highest rating. The rating is then multiplied by the weighting factor to produce a score for each component. The total score for all components will result in the employee s overall performance rating. The following sample form illustrates this performance methodology. SAMPLE - METHOD 1: RATINGS-BASED PERFORMANCE REVIEW FORM Employee Name: JOHN SMITH Review Period: 200X Title: Secretary Review Date: 14/07/0X Key Duties and Responsibilities Weight Rating Score Practice Development 0.20 4.0 0.80 Business Planning 0.15 4.0 0.60 Coordination of Marketing 0.20 4.5 0.90 Financial Operations 0.10 4.0 0.40 Service Standards Physicians receive constant complaints from patients regarding staff courtesy. 0.10 3.0 0.30 Practice Liaison 0.05 4.0 0.20 Personnel Management Turnover, communication, and staff morale need improvement. 0.05 2.5 0.125 Referral Relations 0.05 4.0 0.20 Hospital Relations and Contract Administration 0.05 3.0 0.15 Other Duties 0.05 4.5 0.225 TOTAL 1.00 3.90 2008, BSM Consulting 6

Essential Skills Weight Rating Score Interpersonal and Communications Skills 0.20 4.5 0.90 Decisive Leadership and Judgment 0.20 4.5 0.90 Trustworthiness 0.20 5.0 1.00 Sustains Multiple Simultaneous Tasks 0.20 4.0 0.80 Attentive to Detail and Accuracy 0.20 4.0 0.80 TOTAL 1.00 4.40 OVERALL PERFORMANCE RATING Weight Score Total Key Duties and Responsibilities 0.60 3.90 2.34 Essential Skills 0.40 4.40 1.76 TOTAL 1.00 4.10 Rating: 4.6 5.0 = Far Exceeds Expectations 3.6 4.5 = Exceeds Expectations 2.6 3.5 = Fully Meets Expectations 1.6 2.5 = Meets Minimum Requirements 0.0 1.5 = Does Not Meet Expectations Strengths Describe the employee's greatest strengths: Mr. Smith is well respected by the physicians for his personal integrity, honesty, and ability in ensuring the practice operates efficiently and profitably. Developmental Needs Describe areas needing improvements: Staff communication needs improvement, based on staff survey results. Improvements are also needed regarding maintenance of patient satisfaction levels. Action plan for achieving improvements: 1. Implement staff newsletter and begin biweekly staff meetings to discuss issues. 2. Implement patient satisfaction survey program Additional comments attached by separate sheet? Yes No I. Will Fix, M.D. 14/07/0X John Smith 15/07/0X Supervisor Signature Date Employee Signature Date 2008, BSM Consulting 7

Key Duties and Responsibilities: In this example the practice development component constitutes 20 percent of the value within the duties and responsibilities section while business planning is weighted at 15 percent. The performance rating for practice development is deemed to be 4.0 on a scale of 1 to 5 (5 being Far Exceeds Expectations ). Thus, the resulting score is 0.80 (0.20 x 4.0). The reviewer assigns a rating for each component and then totals the resulting scores as indicated on the form. Essential Skills: In this example, each component within the essential skills section is weighted equally, with each representing 20 percent of the total value. Ratings are applied and scored in the same manner as in the previous section. Overall Performance Rating: The Key Duties and Responsibilities and Essential Skills are also weighted for the Overall Performance Rating. In this example, the duties/responsibilities section accounts for 60 percent of the score while essential skills accounts for the remaining 40 percent. The total score for each component is carried down to the Overall Performance section and multiplied by the applicable weighting factor and total scores indicate the employee s overall rating. In this example, the reviewer has rated the employee at a score of 4.10 indicating his performance Exceeds Expectations. Comments Section: Additional space is provided for subjective comments regarding the employee s strengths, and for commentary regarding areas needing development coupled with an action plan to achieve improvement. The reviewer has identified patient satisfaction and staff relations as the primary goals for improvement over the ensuing period. This form would be used as the foundation for annual performance review meetings between the reviewer and employee to discuss performance and any adjustments in compensation. Each component would be discussed with special emphasis placed on areas requiring improvement. Upon conclusion of the meeting, the reviewer and the employee would sign the form. The employee could attach separate comments for the record if desired. Evaluation forms should be retained as a part of the employee s permanent personnel file. When completing a new form, the prior review form should be checked to assess changes in performance since the time of prior review. Each performance review should include assessment as to whether appropriate progress has been made in the areas identified for improvement. In addition, the reviewer should determine whether the job description is current and accurate, and whether the relative weightings of the components should be modified. Such changes should be undertaken in discussion with the employee and implemented prior to the subsequent assessment period. Most employees have used this method with varying levels of success. However, many employers have found that a discussion-based format can be more effective. This approach provides opportunity to discuss employee strengths and opportunities and avoids overemphasis on a rating number. Instead, the reviewer and employee are more likely to achieve a constructive conversation that leads to useful change. Method 2: Discussion-Based Review (see example on next page) In its basic form, a discussion-based approach includes a self-review by the employee along with assessment by management, allowing identification and discussion of employee concerns and issues. In its more expanded form, discussion-based review utilizes 360-degree feedback, where the reviewer, employee, peers, and doctors are all involved in providing performance input. As with traditional review, a record of the review is prepared in writing for future reference by management and the employee. The discussion-based approach requires much more time for each review compared to the traditional approach, since the nature of the conversation is more open-ended. However, many practices have found that investment to be well worth the time spent. Each practice should adopt and maintain a structure that is useful and practical, avoiding those that are likely to be cumbersome or ineffective. The job descriptions and method of performance review must work within the context and circumstances of the practice. 2008, BSM Consulting 8

SAMPLE - METHOD 2: DISCUSSION-BASED PERFORMANCE REVIEW FORM EMPLOYEE OBJECTIVES NAME: JOB TITLE: DATE: LOCATION: BASED ON THE TIME PERIOD FROM: TO: (This time period should reflect the past 6-12 months) My Accomplishments - What do you consider to be your most important professional/job related accomplishments? My Challenges - List the professional/job related challenges you are currently working through or that you have faced in the last 12 months. Fit List the current tasks and functions within your position that fit your strengths, style and interest. INDIVIDUAL AUDIT Professional Growth / Education List the courses you have attended or wish to attend to further develop in this position. Desire Explain what motivates you and what you find fulfilling in your current position. Value Explain how you feel you bring value to this position. WHAT MY EXPECTATIONS ARE OF MY: Manager Explain your expectations of your manager. Practice Explain your expectations of the practice. HOW MY MANAGER AND THE PRACTICE ARE MEETING MY EXPECTATIONS Manager Explain how your manager is meeting your Practice Explain how the practice name is meeting your expectations. expectations. Describe additional ideas for your manager to further enhance your development. Please indicate any suggestions for the practice to further enhance your development. MY GOALS Professional List the professional goals you have for Personal List the personal goals you have for yourself. yourself. EMPLOYEE SIGNATURE: MANAGER SIGNATURE: DATE: DATE: 2008, BSM Consulting 9

EMPLOYEE PEER EVALUATION TEAM MEMBER NAME: DATE: This form is confidential and will not be seen by the employee being evaluated. Managers are to use this as a tool in providing constructive feedback during the review process. Check all that apply. Treats co-workers with respect Often seems bored and not approachable. At times seems tense and abrupt with co-workers. Continually helpful, warm and friendly. Usually is warm, friendly and approachable. Varies with mood. Reliability (I can depend on my co-worker) Always Usually Never Inconsistent Work Habits Poor work habits, does less than what is required. Does what is required. Always willing to help. Unwilling to help. Able to multi-task. Uses good judgment. Teamwork Does not contribute to team effort and unwilling to try new ideas. Offers suggestions, works well with others, hesitant to try new ideas. Consistent worker, willing to try new ideas, offers suggestions. Proactively attempts to resolve conflict. Communication with co-workers Pays little attention to co-workers and avoids giving out positive feedback. Gives positive feedback but at times doesn t seem sincere. Consistent with positive feedback to co-workers. Open to discussing problems. Overly social, distracting to others. Doing more than the minimum Not helpful, often rude and impatient, unhappy if asked to help. Friendly, but needs to improve put patients first attitude. Defines own role and when he/she is willing to help. Gives more than the minimum to patients. Product or job skill knowledge Has limited knowledge and shows little interest. Some knowledge, interested in knowing more. Knowledgeable. Knowledgeable, interested in knowing more. Proactively pursues growth and development. Willing and able to share knowledge. For additional comments, please continue on backside or another sheet of paper. EMPLOYEE SIGNATURE (OPTIONAL): 2008, BSM Consulting 10

MANAGER OBJECTIVES NAME: JOB TITLE: DATE: LOCATION: LAST REVIEW DATE: DATE REVIEWED JOB DESCRIPTION: (Review current job description) BASED ON THE TIME PERIOD FROM: TO: (This time period should reflect the past 12 months to present.) PERFORMANCE STANDARDS Practice Mission: Practice Vision: Values: Initiative - Honesty & Integrity - Communication - Innovation Respect - Responsibility - Teamwork - Accountability Explain how the employee supports the Mission and Vision. What actions does the employee display that are consistent with the practice core values? CUSTOMER SERVICE (Check all that apply) Attitude toward patients. Often inconsistent/indifferent. Polite, but not approachable. Consistently warm, friendly and outgoing. Ignores patients often. Often rude or unfriendly. Reacts negatively to pressure or unhappy patients. Attitude toward co-workers. Acknowledges co-workers but does not verbally communicate those feelings. Very good at acknowledging co-workers with positive expressions and verbal feedback. Acknowledges/communicates with co-workers voluntarily. Frequently ignores co-workers. Patient/co-worker oriented in pressure situations. When experiences frustration, usually makes no attempt at handling situation. Attempts to resolve situation, then refers to manager. Attempts and usually succeeds in handling situation on own. Wants manager to settle conflict. Reacts negatively under stress. 2008, BSM Consulting 11

MANAGER OBJECTIVES JOB PERFORMANCE / SKILL (Check all that apply) Reliability (others can depend on you). Always Usually Never Inconsistent Attitude toward supervisor and superiors. Resentful, aloof or indifferent. Helpful and cordial. Motivated. Open to constructive criticism. Professional. Defensive and not open to constructive criticism. Product or job skill knowledge. Has limited knowledge and shows little interest. Some knowledge, interested in knowing more. Knowledgeable. Knowledgeable, interested in knowing more. Proactively seeks professional growth or growth opportunities. Quality of work performance. Poor and deficient work performance. Average performance. Meets requirements. High performer. Proactive in improving quality. Understands importance of quality. Ability to self-manage. Requires constant supervision. Requires little supervision. Requires no supervision. Knows when to ask questions. Asks for help when appropriate. Resourceful in finding unknown information. Work habits Poor work habits, does less than what is required. Does what is required. Does more than required. Able to work independently. Unable to work independently. Able to multi-task. Uses good judgment. Accuracy of performance. Very careless and sloppy performance. Tends to be inaccurate. Careful and consistently accurate. Inconsistent. Detailed oriented. Checks work for possible errors. Job commitment. Shows lack of real job commitment. Does an average job but lacks commitment for superior job performance. Dedicated commitment to work and does a thorough job. 2008, BSM Consulting 12

MANAGER OBJECTIVES Ability to prioritize. Needs explicit instruction. Knows how to prioritize. Uses good judgment. Communication skills. Proactively solicits input. Able to communicate both positive and negative information. Open to feedback. Good listener. Communication skills need improvement. Identify Strengths Opportunities for Growth List the top three strengths. List top three areas for growth. 1. 1. 2. 2. 3. 3. EMPLOYEE SIGNATURE: DATE: MANAGER SIGNATURE: DATE: 2008, BSM Consulting 13

EMPLOYEE GOALS NAME: DATE: JOB TITLE: LOCATION: BASED ON THE TIME PERIOD FROM: TO: (This time period should reflect the next 6-12 months.) List professional goals related to current position based on the time period noted above. GOAL Action Plan: Target Completion Date: Follow-up Action Plan: Measurement: Status: Follow-up Completion Date: Measurement: Follow-up Action Plan: Status: Follow up Completion Date: Measurement: CONCLUSION The essential principle of job descriptions and performance reviews is simple: Performance follows accountability. Optimal staff productivity is realized when management and employees understand the duties and responsibilities of the job and the basis by which performance and competency are judged. Job descriptions and accompanying performance reviews are essential tools in achieving staff performance goals. Managers must keep their own performance, attitude, and skills at exceptional levels in order to inspire all employees. 2008, BSM Consulting 14

COURSE EXAMINATION 1. Which of the following is untrue regarding job descriptions? a. Descriptions form the foundation for employee priorities and efforts. b. Descriptions are an optional tool for practices having time to do them. c. Descriptions provide an objective means for measuring performance. d. All are true. 2. In determining a job title, which approach is best? a. The title should be as clear and succinct as possible. b. The title should be expansive to enhance staff feelings of pride. c. The title should be vague and general to allow flexibility. d. None of the above. 3. Employees should be provided a copy of the job description pertaining to their position. a. True b. False 4. Which of the following elements is typically not found in a job description? a. Education and experience required. b. Essential skills and abilities. c. Responsibilities assigned to the position. d. All are typically found. 5. Use of a personality profile in job descriptions can be helpful in determining which of the following: a. The stability of the employee or job applicant. b. Whether job preference will match job requirements. c. Evaluation of employee competency. d. None of the above. 6. Which of the follow aspects is important in determining the viability of a performance review effort? a. The degree of control the employee has over the area of responsibility. b. The degree to which performance within the area of responsibility can be measured. c. The extent to which the review focuses on negative feedback to ensure improvement. d. A and b. e. None of the above. 7. Positive and negative feedback provided during the review process: a. Should be balanced in rough proportion to the employee s overall performance. b. Should be focused more on negative aspects to ensure improvement. c. Should be non-specific to avoid discouraging the employee. d. None of the above. 8. The primary objective of the performance review is to provide a basis for changes in compensation. a. True b. False 2008, BSM Consulting 15

9. Discussion-based feedback is based on: a. Delivering performance reviews in a group meeting of all employees. b. Use of constructive conversation and employee self-review. c. Use of feedback through verbal discussion only, without use of forms or other paperwork. d. None of the above. 10. The term 360-degree feedback refers to an approach where the reviewer circles through the entirety of all possible positive and negative comments pertaining to the individual and his/her performance. a. True b. False 11. Ideally, an employee whose performance needs improvement will leave the review meeting: a. Feeling inspired to improve and having a clear idea of how to do so. b. Fearful of his/her job security and dedicated to improve. c. Confident that positive aspects of performance will outweigh negatives. d. None of the above. 12. The essential principle of job descriptions and performance reviews is: a. Intimidation produces results. b. Feedback always leads to change. c. Performance follows accountability. d. Review equals progress. 2008, BSM Consulting 16