EXECUTIVE SUMMARY

Annual performance evaluations should be conducted year-round and in a thoughtful way that increases their usefulness and helps staff improve their work skills.

One approach is to ask employees for a self-evaluation that includes a list of their three work goals and three personal goals.

Use findings and the employee’s goals from the previous year’s evaluation to compare with the current year to see if performance has improved and the employee’s goals were met.

Goals for administrators can include taking the Certified Administrator Surgery Center exam, participating in a state association, writing professional articles, and speaking at national meetings.


Mention the annual job performance evaluation, and chances are everyone will run in the opposite direction. Many employees and managers dislike them. But they must be conducted, so why not do them well? “Performance evaluations are done sort of haphazard,” says Ann Geier, MS, RN, CNOR, CASC, chief nursing officer, Surgical Information Systems, LLC in Alpharetta, GA. “There’s a lack of training for managers on training evaluations. The forms are usually poorly designed, and it’s very subjective, just a matter of opinion.”

Geier offers a few suggestions for improving the performance evaluation process and making it useful as part of a surgery center’s mission to deliver high-quality care:

Make performance reviews a year-long process. Some surgery centers will conduct all employee reviews at the start of each new year or on a predetermined date. While there might be some appeal to setting aside time once a year for these, it is not necessarily the most efficient or best way to handle the annual review process.

“A lot of companies do it on a calendar year basis where everyone’s evaluation is due on the same day,” Geier observes. “If you have 50 employees to evaluate at one time, it opens a whole slew of issues.”

When performance reviews are conducted at the same time each year, they might start off strong, but fall off toward the end, she notes. “You will get tired of doing them and go through them quickly,” Geier says. “By the time you get to the last eight or 10, you’re hardly looking at what you’re reading and are not paying attention to the actual evaluation.”

The better process is to stagger evaluations, perhaps handling them on the anniversary of employees’ hiring dates. Also, Geier recommends managers keep notes on employees’ performance throughout the year. When there are issues or opportunities for praise, managers should notify employees in real time.

“There shouldn’t be surprises,” Geier says. “If you give bad news at the evaluation, then that’s your fault; there should be feedback all year.”

Empower employees to participate. “I empower employees to remind me a month ahead of their work anniversary that my evaluation is due,” Geier says. “When I schedule time for an employee’s evaluation in my calendar, that says to the employee that this is important.” One of Geier’s first steps is to hand employees a self-evaluation to complete.

“What’s important to me about the self-evaluation are the employee’s goals,” she says. “What are the employee’s three work goals and three personal goals?”

Employees bring their self-evaluations with them to the performance evaluation meeting. The manager’s evaluation is completed before the manager sees the self-evaluation. One way to make performance evaluations useful is to compare the employee’s self-evaluation with the supervisor’s evaluation and to discuss any differences in the meeting with the employee, Geier says.

Also, Geier compares the employee’s professional goals from the previous year’s evaluation with the goals the employee met in the past year. The idea is to see if the employee succeeded in achieving those goals, she explains. “If employees didn’t succeed, I ask, ‘Where did I let them down?,’ not ‘Where did they fail?’” she says.

For example, if one of an employee’s goals is to become a certified infection preventionist, but the employee never earned this certification, Geier would consider how she, as the supervisor, never did anything to help the employee sign up for classes for certification. “I have a different take on evaluations, but I take them very seriously,” Geier says.

Another approach for making employees comfortable during the performance evaluation meeting is to ask the employee to sit at a right angle to the supervisor, Geier explains. “If you sit straight across from one another, it’s a power play,” she says. “If you face them, then it’s you against them, and it’s not collaborative.”

But when the pair sit at right angles to each other, it creates an environment open to dialogue, Geier adds. Meeting at a round table also can be effective. “It removes that barrier between management and employees,” Geier says.

Keep it personal, confidential, and fair. When supervisors hold performance evaluation meetings, they should keep the meetings private, confidential, and behind closed doors. A ‘do not disturb’ sign could be placed on the door to prevent interruptions. “Make the encounter comfortable, and give the evaluation to the employee to read,” Geier says.

Supervisors should explain their findings and scoring on the evaluation form. If each performance item is scored from a one (poor) to three (meeting expectations) to five (best), a supervisor should let employees know a little about how those numbers are determined. A performance indicator about wearing OR clothing might only receive a score of three. “You can meet that expectation, and you can’t exceed it,” Geier explains. “Some employees think their performance is perfect and they should get all fives. I have to explain to them that in some situations, you can never achieve a five. You either do it or don’t do it.”

Any scores of one or five should include a comment explanation. “If it’s a five on a performance item related to working with the patient and family, it can be a comment, saying, ‘You excel in conversations with the family,’” Geier says. “Then, you can use an example about how one family was upset about something while waiting in the waiting room, and the employee gave the family a restaurant gift card.”

If a score is a one or two on the attendance performance indicator, then the comment might note that the worker had been late three days out of 20 days in March, Geier adds. Any performance reviews that include ones and twos, indicating poor performance, should not be a surprise to the employee. These problems should have been discussed with the worker when they occurred, Geier notes.

Discuss findings and set goals. “We should be in agreement on the evaluation, and if not, let’s discuss it,” Geier says. “’I rated you this, and you rated yourself this, so let’s discuss it.’”

Geier focuses on the employee’s goals and helps them provide specific actions they’d like to take. For example, an employee might set a personal goal of creating a better work-life balance. The supervisor can ask the employee to specify what might need to change for the worker to meet this goal.

“We can discuss it, and the employee might say, ‘I’d like to leave on time every day,’” Geier says. “An employee might make it a personal goal to take vacations because the person had been carrying the vacation days over from one year to the next.”

Another worker might make a professional goal to become a certified infection preventionist, so the supervisor can suggest they talk about that after the evaluation is complete. Geier once encouraged a business manager to take coding classes to become a certified coder. The employee did this and became certified.

It is the supervisors’ role to help employees grow professionally through setting goals that stretch their skills. For administrators, Geier suggests they set four goals: Take the Certified Administrator Surgery Center exam, be an active participant in a state association and serve on a committee, write an article for a national publication with a surgery center focus, and speak at a national meeting.

“Their immediate response to being asked to speak is to say, ‘I can’t do that,’ but I say, ‘You can do that, and I’ll help you do that,’” Geier says.

Make process positive. “Set up your employees and managers to succeed,” Geier says. “It’s a positive experience.” Clear communication helps with creating a positive environment. Supervisors should explain how pay raises resulting from the performance evaluation results are determined. If there’s a cap on the percentage of increase, explain what that percentage is and who is eligible for the maximum.

“Not everyone is at a 5% increase level,” Geier notes. “You have great employees that meet all expectations and do their job well, but they won’t get to the next level. Then, you’ve got employees who have initiative and volunteer to do extra projects, and they deserve a bigger increase.”

Geier shows employees she cares about their professional development, even to the point where she will help them move up to a position outside of her own organization.

“I’m asked all the time, ‘Why do you do that?’ I say, ‘Because, you’re going to lose them anyway; they’ll find something else to do, so we help each other, and it never stops,’” Geier explains. “It’s paying it forward, and at some point, I’ll have to retire. I am training my replacement, somebody to return to take my place. I hope it’s somebody who has the motivation and love for this industry that I have.”