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Florida Association of Community Health Centers
2009 Annual Conference
Performance Management, Employee Retention & Motivation
Mark E. Robledo, The Crossroads Group, Inc.
04/10/23 ©2009. The Crossroads Group, Inc. 2
Who We Are
The Crossroads Group, Inc.• Speaker: Mark Robledo, M.B.A., President and
Founder • Specialization: Organizational development, with
particular emphasis on delivering measurable outcomes.
• Mission: To help clients assess and achieve measurable client goals and objectives.
• Founder serving FQHCs since 2000
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The Crossroads Group Core Competencies
Community Health Centers
Core Services:Strategic Planning Facilitation/PreparationPatient Satisfaction/Experience Measurement and
ImprovementEmployee/Provider Perception Surveys and Focus
GroupsProcess Improvement/Patient Flow ImprovementTraining and Development
For more information and references: www.CrossroadsGrp.com/chc.htm
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Process + People PerformanceTwo Sides of the Same Coin
ProcessPerformance
HumanResource
Performance
OrganizationalPerformance
Our Focus Today
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What is Performance Management?A Primary Management Function for all Managers and Supervisors
• Performance management is an ongoing communication process, undertaken in partnership, between an employee and his or her immediate supervisor that involves establishing clear expectations regarding job functions, organizational goals (and relationship to), performance feedback, performance measurement, barrier removal, and continuous improvement. Bacal, Robert. Performance Management. New York: McGraw-Hill. 1999.
04/10/23 ©2009. The Crossroads Group, Inc. 6
Why Performance Management?
Why so Important? People are the most strategic asset and the greatest investment Delivery of all organizational goals and mission depends on people Most health center managers are poorly equipped to manage
subordinate performance (technically but not managerially proficient)
Performance Management Directly Impacts: Employee Retention, Engagement, and Commitment Employee Productivity and Efficiency (all levels) Process Performance Service Excellence, Patient Satisfaction, and Community Image Financial and UDS Metrics
04/10/23 ©2009. The Crossroads Group, Inc. 7
Performance Management QuotesWhat High-Profile Business Leaders Have Said
• “My main job was developing talent. I was a gardener providing water and other nourishment to our top 750 people. Of course, I had to pull out some weeds, too.” (Jack Welch)
• “The conventional definition of management is getting work done through people, but real management is developing people through work.” (Agha Sahab, Founder of Bank of Credit & Commerce Int’l BCCI)
• “(A) myth of management is that success equals skill.” (Robert Heller)
04/10/23 ©2009. The Crossroads Group, Inc. 8
Performance Management Quotes
• “Executives owe it to the organization and to their fellow workers not to tolerate nonperforming individuals in important jobs.” (Peter Drucker)
• “Endeavors succeed or fail because of the people involved.” (Colin Powell)
• "Never try to teach a pig to sing; it wastes your time and it annoys the pig.“ (Paul Dickson)
• "So much of what we call management consists in making it difficult for people to work.” (Peter Drucker)
Performance Management QuotesDealing With Poor Performance
• “I feel that there is no greater disrespect that you can do to a person than to let them hang out in a job where they are not respected by their peers, not viewed as successful, and probably losing their self-esteem. To do that under the guise of respect for people, is to me, ridiculous.”
(VP Strategy and Corporate Relations Hewlett Packard)
• “It’s incredibly demoralizing for the rest of the team if you don’t move poor performers out – and the leader looks blind and out of touch.” (Senior Executive, Arrow Air)
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Why Managers Don’t Manage“Management Must Manage” (Harold Geenen)
• Ill Equipped – lacking tools and basic skills• Fear of being perceived as a “micro-manager”• Perceived Lack of Time
Not seen as a priority Busy “Putting out fires”
• Emotional barriers/fear of confrontation• Not able to delegate
Easier to “Just do it” than to delegate to someone else
“It is not necessary to change. Survival is not mandatory.” (W. Edwards Deming)
Leverage
Failure to Manage r
• Results: “Lose the best, keep the rest…”
• Costs of Turnover (direct and hidden)Direct: Recruitment, replacement, on-boarding, training
and development, Indirect:
– Additional burden on staff (coverage and training)
– Adverse effect on morale, knowledge drain
– Adverse impact on patients (image, relationships)
• Suggestion: Create sense of urgency. Run a turnover cost calculator for your organization.
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Eight Key Elements of Performance ManagementAdditional Emphasis
1. Goal-setting (for new or established employees)
2. Motivation
3. Monitoring Performance
4. Gap Closure and Improved Performance
5. Coaching
6. Performance Appraisals
7. Development
8. Addressing Intractable Performance Problems
04/10/23 ©2009. The Crossroads Group, Inc. 13
Goal-Setting
• Goals are not job description activities Goal provide the reason for activities. All activities should be
linked to a specific goal or goals. • While all are important, should be prioritized (e.g. service
vs. efficiency) accurately measured • Goals must be…recognized as important (by owner), clear,
specific, measurable, timely, aligned with strategy, achievable but challenging, supported by appropriate and meaningful rewards (must be a meaningful “stake” in the outcome for the employee).
04/10/23 ©2009. The Crossroads Group, Inc. 14
Individual Goal-Setting (Cont.)
How to set goals with employees• Discuss goals with employee. Obtain agreement (2-way)
Clarify importance (reason for) of goals Dialogue How To Aspect Adjust participation according to KSA and employee level
• Record Goals (copy for manager and employee) Develop action plan (best driven by employee) Record date of meeting, the goals (and targets), the actions,
resources (coaching, training, other), date of next assessment.
04/10/23 ©2009. The Crossroads Group, Inc. 15
Individual Goal-Setting (Cont.)
• A Note on “Soft” Goals:Do not neglect to include. Tend to often be left out in
favor of “hard measures” (volume or UDI measures), but equally critical and supportive of.
– Often lead the harder lag indicatorsExamples include customer perceptions, employee
perceptions, public perception, internal service, manager behaviors.
Tools: Internal and external surveys, focus groups, mystery shop
04/10/23 ©2009. The Crossroads Group, Inc. 16
Monitoring PerformanceBeyond the foundations
• Observe and gather data
• Avoid premature judgments or assumptions
• Consider other sources of information (validate with peers)
• Attempt to differentiate between skill and/or motivation issues
• Examine yourself. Managers may hinder performance by micromanaging the how, providing insufficient resources, not being available, or setting unclear or unrealistic time frames. Poorly designed processes may also contribute. Periodically “Step into their shoes” (spend time in their work area)
04/10/23 ©2009. The Crossroads Group, Inc. 17
Gap Closure
• Performance Discrepancy or Gap: A mismatch between what employees are actually doing and what they should be doing, based on established manager/supervisor expectations.
• First assessment step:1. Are expectations realistic?
2. Assess the cost (impact) of the discrepancy
3. Is there a fast fix?
04/10/23 ©2009. The Crossroads Group, Inc. 18
Gap Closure
• First Step: Differentiate whether the issue is a process issue (beyond employee), a skill issue, or a motivational issue.
• Validate over time (pattern) and with peers.• Be aware of (and sensitive to) other factors,
particularly when performance decline is sudden:
Personal problems Relational conflicts at work Work overload or burnout
04/10/23 ©2009. The Crossroads Group, Inc. 19
Gap Closure
• Addressing with the Employee: State the observation
– Use metrics where available
Discuss behaviors, never presume motives State the implications: (Example) Plan follow-up actions
04/10/23 ©2009. The Crossroads Group, Inc. 20
Coaching Basics: Practical Suggestions
1. Most powerful and readily available (ideally) tool in performance management
2. May address either performance or skill gaps3. Can be delegated to others ‘Coach the coach”,
especially for skill training (leverage)4. Best weighted towards employees with potential
for growth or on verge of promotion to new role Secondary Benefit: Causes the employee to be
valued. Meets need for growth and challenge.
04/10/23 ©2009. The Crossroads Group, Inc. 21
Coaching Basics (Cont.) Practical Suggestions
5. Let new hires know to expect coaching as a normal part of management process.
6. Recommend creating a custom “Coaching Opportunity List” of your subordinates.
7. Build agreement as to the need for coaching beforehand. Performance Gap “Next Level” knowledge
8. Follow-up action plans With input from the employee
04/10/23 ©2009. The Crossroads Group, Inc. 22
Coaching (Cont.) Situational Leadership Model
DI RECTI NGLow Com petence
HighCom m itm ent
(1)
DELEGATI NGHigh Com petence
HighCom m itm ent
(4)
COACHI NGSom e Com petence
Som eCom m itm ent
(2)
SUPPORTI NGHigh Com petence
VariableCom m itm ent
(3)
Su
pp
ort
ing
Be
ha
vio
r
D irecting Behavior
LOW
LOW
HI GH
H I GH
S ituational Leadersh ip Model ( Hersey, B lanchard)PRIMECOACHINGSTAGE
04/10/23 ©2009. The Crossroads Group, Inc. 23
Coaching (Cont.) Important Considerations
1. Climate: Mutual trust, accountability, and growth
2. Keep focus of feedback on future3. Provide timely feedback4. Focus on specific behaviors or metrics, not
character, attitudes, or personality5. Be specific
• E.g. Praise vs. Positive Feedback
04/10/23 ©2009. The Crossroads Group, Inc. 24
Motivating Employees
Extrinsic Rewards vs. Intrinsic Rewards1. Extrinsic more commonly focused on by
administrators (e.g. pay)– Most effective for recruiting
2. Intrinsic more powerful and readily available – Growth opportunities, meaningful work,
teamwork, positive work environment. Extrinsic dissatisfaction may be (but not
always) rooted in lack of intrinsic reward.
04/10/23 ©2009. The Crossroads Group, Inc. 25
Intrinsic and Extrinsic DriversKey Drivers of Overall Satisfaction
1. Benefits and Compensation2. Job Security3. Communication With Management4. Work/Life Balance5. Relationship With Supervisor6. Career Development Opportunities
Source: Society For Human Resource Management (SHRM), 2003
04/10/23 ©2009. The Crossroads Group, Inc. 26
Satisfaction MetricsSatisfaction Survey Results
(Recent Crossroads Group Survey)
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Importance MetricsImportance Survey Results
(Recent Crossroads Group Survey)
10 Practical Ways to Motivate and Retain Strong Performers
Source: Harvard Business Essentials. Performance Management, 2006.
1. Demonstrate trust
2. Make jobs more complete
3. Introduce challenge
4. Encourage some to become experts
5. Drive out fear
6. Preserve subordinate dignity
7. Address poor performance
8. Empower, don’t micromanage
9. Hire self-motivated people
10. Be a good boss
04/10/23 ©2009. The Crossroads Group, Inc. 28
Intrinsic MotivationFour Building Blocks
1. Cultivate meaning awareness Positive work environment, vision, purpose, relevance, wholeness of tasks
2. Develop a sense of choice Delegated authority, trust, security, clarity, information
3. Develop a sense of competence Knowledge, positive feedback, skill recognition, challenge, standards
4. Develop a sense of progress Collaboration, milestones, celebrations, access to customers,
improvement measuresSource: Thomas, Kenneth W. Intrinsic Motivation at Work- Building Energy and Commitment. San Francisco: Berrett-Koehler Publishers Inc. 2000.
04/10/23 ©2009. The Crossroads Group, Inc. 29
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ExpectancyTheory of Motivation
Motivating Employees to Meet GoalsExpectancy Theory
MF= Motivation Force (towards goal achievement)
MF = Expectancy x Instrumentality x ValenceExpectancy asks: “Can I achieve the goal” (targets and skill level)
Instrumentality asks: “Is achievement (or non-achievement) of the goal linked to a reward (or consequence)?” Does it matter?
Valence asks: Is the reward (or consequence) meaningful to me?
04/10/23 ©2009. The Crossroads Group, Inc. 31
Generation Y: Unique Factors (Born 1978-1998)
• Generational Factors: Entry-level EmployeesOver 14 million in workforce and growing Independent, tech smart, self-reliant, like flexibilityHigh expectations for rapid career growthGreater demand for work/life balanceHigh need for clear and frequent performance feedbackWant to be “paid volunteers” Independent, but with high socialization needsHardest group to retain
04/10/23 ©2009. The Crossroads Group, Inc. 32
Performance Appraisals
• A formal method of assessing how well an employee is doing with respect to assigned goalsA natural extension of the performance management
continuumSoftware applications may assistAllow employee opportunity to self-evaluateSuggested 4 point Rating Scale: Did not meet
expectations, Developing, Proficient, Role Model
04/10/23 ©2009. The Crossroads Group, Inc. 33
Performance Appraisals
• Common PitfallsA formal annual exercise with little real meaning
– Requires training for quality and consistency
– Requires real and honest evaluation, consistent with pre-established goals, coaching discussion, and measures.
Delays due to time-consuming nature, fear of confrontation (by manager), and staggered load (all at the same time).
– Delays a major dissatisfier for employees (do not care message)
04/10/23 ©2009. The Crossroads Group, Inc. 34
Employee Development
• A key to retention, particularly for high-potential employees
• Convergence of: Company/department goals and objectives Employee aspirations and interests Employee development needs
• Assessment tools include communication, learning needs assessment surveys (manager and employee perspective), and KSA inventory databases.
• Tip: To avoid burning out talented employees, scale up and down (job re-design) when delegating new responsibilities.
04/10/23 ©2009. The Crossroads Group, Inc. 35
Intractable Performance ProblemsConfronting Poor Performance (when all else fails)
• Confront poor performanceBased on a pattern of observation rather than an
isolated event.Directly (and privately) with the individual (not to a
group)Be specific about nature of the problem and the
ramifications on the organizationListen activelyMake specific suggestion or request. Keep a record of
what was said and agreements made.
04/10/23 ©2009. The Crossroads Group, Inc. 36
Intractable Performance ProblemsWhat About “C” Performers?
The Toughest Challenge:• C Performers- do just enough to get by
Do not respond to performance management efforts
• Manager Barriers: Psychological and Practical• Impact of Ignoring C Performers:
Discredits leadership Block advancement of A and B Performers Poor Role Models/Examples Stifle enthusiasm of new hires and A and B performers Cause good performers to settle or leave C-performers multiply (hire other c-performers)
04/10/23 ©2009. The Crossroads Group, Inc. 37
Intractable Performance ProblemsSteps to Address
• Decide to do something (first step)• Use “Iron Hand, Velvet Glove” approach• Identify A, B, and C Performers directly reporting to you.
(multi-rater system and scorecard)• Develop action plan with C performers through coaching
or performance evaluation process. • Hold Managers/Supervisors accountable for improvement
and/or removal of their C performers.• Look for “C” Clusters
Manager/Supervisor Issue Process improvement opportunity
04/10/23 ©2009. The Crossroads Group, Inc. 38
Intractable Performance ProblemsWhen to Dismiss
Dismissal Almost Always Justifiable For:1. Consistently performing poorly (using objective criteria) on the
job2. Refusing to following instructions3. Have a persistently negative or destructive attitude4. Insubordinate behavior/disrespect of authority5. Abusing sick leave or other privileges6. Being chronically late or absent
1. Must be brought to employee’s attention, be documented, and persist thereafter.
2. Consult your HR Department/legal department for specific HR policies and procedures and/or state laws.
Recommended Resources
• Cole Miller, Brian. Keeping Employees Accountable for Results. New York: American Management Association, 2006.
• Thomas, Kenneth W. Intrinsic Motivation at Work- Building Energy and Commitment. San Francisco: Berrett-Koehler Publishers Inc. 2000.
• Harvard Business Review on Appraising Employee Performance. Boston: Harvard Business School Press, 2005.
• Bacal, Robert. Performance Management. New York: McGraw-Hill. 1999.
• Mager, Robert F., and Peter Pipe. Analyzing Performance Problems. Atlanta: Center for Effective Performance Press, 1997.
• Coaching and Mentoring. Boston: Harvard Business School Press, 2004.
04/10/23 ©2009. The Crossroads Group, Inc. 39
04/10/23 ©2009. The Crossroads Group, Inc. 40
ConclusionFollow-up Q&A, Contact Information
• Q&A
• Shared Best Practices
Mark E. Robledo
President, The Crossroads Group, Inc.
Tel. 888-412-0160, Direct 305-412-0160.
merobledo@crossroadsgrp.com
www.CrossroadsGrp.com/chc.htm
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