Managing Staff

Documentation is very important in the hiring, firing and performance management process. Take the time to do things properly (offer letter, termination letter, performance reviews, etc.) and it will save you time, frustration and money in the long run!

Leadership Assessment

How do you currently make decisions? Do you know what your practice will look like three years from now? A plan can help you define your unique features, prioritize your financial needs, communicate your strategy to your staff and provide direction to them. You can start with these key questions:

  • What is your mission statement?
  • What is your vision statement?
  • What can you and your clinic do better than anyone else?
  • What are your short-term goals and priorities?

Answering these questions on a regular basis, whether annually or quarterly, will help you and your staff stay on track.

Engaging and Motivating Your Staff

It’s important to engage and motivate your staff. Whether it’s a “job well done” or physical reward, positive reinforcement goes a long way in making people feel appreciated and wanting to contribute more.

Research has shown that ‘engaged employees’ are more loyal, satisfied and productive than disengaged ones. Engaged employees feel valued and show more initiative and make greater team contributions at work. The more motivated an employee is at work, the more they strive for excellence and the better they perform. Employers who make an effort to keep their staff engaged and motivated get the best out of their people and increase employee retention.

So what’s the secret to engaging and motivating your staff? Believe it or not, financial compensation is not one of the top drivers.

The primary drivers for employee engagement are:

  1. Relationship with one’s manager;
  2. Enjoyment of the work;
  3. A belief or pride in the organization and what it does/stands for.

Communicate, stay connected and provide frequent feedback. These are the essential building blocks to strong, trusting and productive relationships with your staff.

Other factors which drive engagement and motivation at work include pay, reward and recognition, career opportunities, professional development and the reputation of the business. Each of the chiropractors interviewed during the development of this resource had employee engagement strategies in place. These included performance based bonuses, professional development opportunities, the opportunity to work on special projects and ad hoc rewards such as gift cards and a day off for a job well done.

Tips to Engage and Motivate your Staff

Create a harmonious and inclusive work environment through team activities and outings.

  • Recognition: Recognize employees for a job well done or a contribution made. You can do this in the simple form of verbal feedback. Praise from one’s manager makes an employee feel appreciated and valued. This non-monetary form of recognition has great impact and should not be under-estimated.
  • Professional Development: Allow and encourage employees to attend conferences such as OCA workshops or other courses that will facilitate professional development (i.e. Microsoft Project, Excel, business planning, communication, etc.).
  • Team Spirit: Small activities and rituals such as team lunches and taking turns bringing donuts or refreshments into the office can promote team spirit and make people feel good. Celebrate birthdays with a cake or a group lunch and do something in the summer (picnic or BBQ) and at Christmas time (holiday party) that shows your appreciation for your teams’ hard work and contribution throughout the year.
  • Reward: Physical rewards also go a long way in making people feel appreciated. Rewards can come in the form of money (e.g. bonus), gift cards, movie passes, time off, etc.   These kinds of rewards are discretionary and usually reserved for contributions or tasks that require a great deal of time and effort or are above and beyond the scope of one’s regular work. An example is an office assistant that took the initiative to research different telephone and internet providers and secured a contract that saved the clinic $200 per month.
  • Career/Development Opportunities: A promotion may not be realistic given the needs and structure of your practice, but you can be creative with development opportunities that still support business needs. These could include assigning special projects, cross-functional training and filling in for someone more senior as a back-up.
  • Frequent Feedback: Delivering feedback once a year in the form of a performance review does not keep employees motivated. Research shows that employees are more engaged when feedback is delivered on a frequent basis.  Weekly meetings are recommended to review the previous week and plan for the upcoming week. This is a great way to stay connected with your staff and understand what’s happening  on the ground level of your practice.
  • Effective Relationships: Communicating and connecting with your staff is critical. Demonstrate respect, honesty, integrity and trust. Show that you care and that you value employee input and opinions. Ongoing communication is essential to achieve this. Be accessible to your employees and listen to their questions and concerns. Offer your support as a manager and work with them to achieve professional success. It is also recommended to ask questions about one’s personal life such as family, personal interests, etc. Most employees appreciate this and it often strengthens the relationship. That being said, navigate this area carefully as there are always some individuals that prefer to keep their personal life separate.
  • Bonus: Bonus incentives are great motivators when they are achievable. Setting bonus targets that are largely unattainable have the opposite effect and disengage employees.

Tips to Conduct a Performance Review

Performance reviews are usually conducted annually and are a more ‘official’ way of providing feedback. If you are providing regular feedback throughout the year, there should be no surprises when conducting an annual performance review. Take this opportunity to discuss goals and objectives for the coming year and describe what success will look like. This provides a benchmark on which to measure performance at the next review.

  • Schedule meeting in advance and hold it in a private place with no interruptions
  • Provide an opportunity for the employee to express a self-assessment of their performance – what they feel they have done well and what areas they feel need improving
  • Deliver positive feedback first. Tell the employee what they do well and provide examples
  • Collect feedback from peers, patients and others that the employee works with on a regular basis. Summarize and communicate that feedback to the employee. It is good for him or her to know how they are perceived by others
  • Deliver any constructive feedback and discuss areas for improvement. Sometimes these are not areas of improvement, but rather areas that you want to grow or develop the person in. For example, you may want the Office Assistant to start doing billings
  • Provide a concrete rating that reflects overall evaluation of performance. This rating can be numerical or verbal (i.e. meets expectations, exceeds expectations, does not meet expectations). Whatever the rating, support it with examples and document it. You may ask the employee to sign off on the review – this is optional
  • Discuss goals and objectives for the upcoming year. Define what success/achievement will look like and how the employee will be measured

Best Practices for Developing a Performance Improvement Plan

A solid performance improvement plan should reflect the following:

  • An understanding of the performance gap and expectations regarding what is to be achieved.
  • Clear understanding of the responsibilities and deliverables expected by the employee.
  • Clear understanding of the responsibilities and role the Employer will play in helping the employee improve (i.e. additional training, frequent feedback, check-in meetings, etc.).
  • How progress will be measured and success will be defined (i.e. what milestones).
  • Specific time frames for improvement. There may be one or there may be many, depending on the problem. Be sure to allow sufficient time for performance to improve.

Dealing with Underperforming Employees

Deal with underperforming staff as soon as you notice a pattern or problem. Address it one-on-one and prevent it from turning into something bigger.

Poor performance can manifest itself in different ways. It can be a failure to perform the duties of the position; not adhering to workplace policies, rules or procedures; or disruptive and unacceptable behaviour in the workplace. Reasons for underperformance can include:

  • Employee doesn’t know what he or she is expected to do
  • Mismatch between employee’s capabilities and the job they were hired to do
  • Employee not provided with the skills or knowledge to do the job
  • No feedback on performance has been provided
  • Difficult personality
  • Low morale in the workplace
  • Personal issues such as family stress or health problems

Note that the first few reasons in the list above can be prevented with an effective hiring and training process and employee engagement strategies at work. That being said, poor performance should be addressed right away because it is unlikely that the employee knows there is a problem. If someone doesn’t know there is a problem, there is little chance of them changing their behaviour on their own. For example, if someone is late for work a few days in a row, don’t let it carry on. Have a one-on-one conversation with that person and say you have noticed that they have been coming to work late. You can ask if there is a reason why – perhaps they are dealing with something at home – and emphasize that you need them to be punctual and arrive at X time every day. If the problem continues to persist, have another conversation and communicate consequences such as a written warning, documentation in his or her performance review, no bonus, etc.

Five Step Plan

When managing underperforming staff, here are 5 helpful steps to follow:

  1. Identify the problem: Before you take action, clearly identify the problem. Is it attitudinal or behavioural? Is it an isolated incident or a series of occurrences? Is the problem specific to one area or is it the person’s overall performance?
  2. Analyze the problem: Explore the possible reasons contributing to the problem. Has there been a significant life event or disappointment at work? Have dynamics in the workplace changed with respect to hours, supervision or the introduction of new co-workers?  Next try to determine how serious the problem is.  How long has it has been happening? Is this a departure from normal behaviour? How big is the gap between where performance needs to be and what is being delivered?
  3. Discuss the problem: If possible, deal with immediately (never in front of patients or coworkers). When applicable schedule a meeting with the underperforming employee to discuss the problem. Let him or her know the purpose of the meeting so you don’t take them by surprise. Hold the meeting in private (not in front of patients or coworkers) and ensure you will not be interrupted. Explain to the employee specifically what the problem is, why it is a problem and the impact it has had at work. Allow the employee to speak freely and express his or her opinions, comments and point of view. Finally, communicate the outcomes you wish to achieve.
  4. Develop a performance improvement plan: Where possible, it is encouraged to jointly come up with a solution to address the problem. An employee who contributes to the solution is more likely to accept it and act on it. This solution can be referred to as a performance improvement plan. Set time frames for completion and schedule future meetings to review the employee’s progress and performance against the agreed upon plan. Keep a written record of all discussions in case further action is required.
  5. Monitor performance: Monitor the employee’s performance and continue to provide regular feedback. You are working to resolve the problem, so foster a climate of encouragement; not one where the employee feels like his or her head is on the chopping block.Once the problem has been dealt with and performance has improved to an acceptable level, meet with the employee to acknowledge the issue has been resolved. Be prepared to work with the employee to ensure that good performance is sustained.If performance does not improve to the required standard and the problem cannot effectively be resolved, more serious action may needed such as a formal written warning or termination of employment.

Performance management must be a participative process in order to work. If the underperforming employee at no point takes accountability or shows a desire to change the situation, performance will undoubtedly not improve. The above steps may seem like a lot of trouble and effort to go to in order to fix a problem. You may feel it’s worth the effort for some and in other cases you may feel that termination is truly the best solution for both parties. The reality is our laws heavily protect the rights of the employee, so going through these steps and pursuing corrective action before resorting to termination will go a long way in preventing legal claims.