Managing Performance

Workshop outcomes, participants will: RACMA Partnering for Performance 2010 Understand benefits of appropriate performance management Understand the process of feedback Have increased confidence about giving and receiving feedback 2

Program outline RACMA Partnering for Performance 2010 Session One: Introduction Session Two: Providing Practical Feedback Session Three: Documentation of the feedback process Session Four: Review and development of action plans 3

INTRODUCTIONS CONCERNS ABOUT THE PROCESS RACMA Partnering for Performance 2010 Session One What is Performance Management ? 4

Implementation RACMA Partnering for Performance 2010 Write down 4 concerns you have regarding the performance management process for doctors on 4 post it notes Discuss and categorise them with your group Are there any recurring themes? 5

PRINCIPLES OF FEEDBACK PURPOSE OF FEEDBACK PRACTICAL FEEDBACK TECHNIQUES FEEDBACK CONVERSATIONS RACMA Partnering for Performance Session Two: Providing practical feedback

Experiences of feedback Reflect on your experiences both in giving feedback and receiving feedback in your professional role: What have you learnt about:  Defining what feedback is  Principles of effective feedback  The purpose of feedback  Effective and practical feedback techniques- what works and what doesn’t  Documentation of feedback Discuss these and document in your group RACMA Partnering for Performance

What is feedback? Letting someone know on a timely and ongoing basis how they are performing, Includes both positive and negative observations This feedback should be given independent of any formal performance review process RACMA Partnering for Performance

Why give feedback? People often do not know how well they are doing People assume that they are doing a good job if no- one tells them differently  They may be outstanding at what they do and should be encouraged to continue in this way and teach others  They may be sub-standard and not realise they need to improve their performance Managers need to make effective feedback a normal part of their work with others so as to continuously improve standards of care and service delivery RACMA Partnering for Performance

Principles of giving effective feedback RACMA Partnering for Performance Should be given uninterrupted time to do well Should be given in relation to a specific goal or action Avoid judgemental language Be direct and clear Consider the needs of both the giver and receiver Need to plan how to give effective feedback Should be aimed at enhancing performance- Cover both things that are being done well and those that may need improvement Encourage feedback from others

Principles of receiving feedback Actively ask for feedback in specific areas or your work Listen to the feedback and clarify you have understood Try not to react defensively to negative feedback or be ungracious with positive feedback – impacts on the giver in being able to honestly do this in the future Focus on your behaviour and its impact rather than on detailed explanations Remember that feedback is that person’s perception rather than a universal truth ( if a lot of people feed back the same thing- then it may be a universal truth!) Show appreciation for the feedback Indicate what you will do to change RACMA Partnering for Performance

Purpose of Feedback RACMA Partnering for Performance Feedback is of no value unless the person receiving the feedback perceives it as appropriate and is prepared to change their behaviour as a result  But - being prepared to change behaviour is not enough  The next step is actually making the change In addition, feedback should also be positive where deserved  The aim of this is to reinforce and maintain acceptable behaviour and to enhance motivation Research has shown that developing a moderate strength into a significant strength is often of more value than fixing the negatives

Feedback is often seen as a threat Why is feedback threatening? For the person fed back to:  No- one likes to be considered incompetent- especially doctors who have always been at the upper echelons of intelligence  People are not good at receiving negative feedback- get defensive, blame the messenger for negative feedback  Do not know how to be gracious about positive feedback For the person feeding back  Feedback is seen by many as “unnatural” especially at peer level  Many people feel they do not have the skills to give effective feedback RACMA Partnering for Performance

Using feedback to enhance competence Everyone likes to feel they do everything well However none of us is expert at everything We are all better at some things than others and this is related to many factors such as natural ability, opportunity to learn and enhance skills, personal interests, career path etc Effective feedback- whether aimed at praising superior skills or focusing on areas for improvement- provides an opportunity for doing our work better and contributing to enhanced patient care and service delivery RACMA Partnering for Performance

Feedback conversations Two types of feedback conversations  Occur as a result of a specific event  Form part of a regular formal performance conversation RACMA Partnering for Performance

Feedback conversations Read through the case study and make notes on how you would approach this conversation Discuss in your group and come to a consensus approach RACMA Partnering for Performance

Feedback techniques RACMA Partnering for Performance Positive feedback  Indicate what the person did – specifically  Tell them that you liked what they did E.g.  “That meeting was so well run. We got all of the outcomes we planned and more! Thanks you did a great job.”  “I can’t believe how well you managed that difficult complaint. It was obvious the patient and their family went away feeling they had been heard. I really appreciate your efforts and would like you to get involved in teaching others your techniques.”

Practical Feedback Techniques RACMA Partnering for Performance 2010 Negative feedback  Don’t do in the heat of the moment, work out an approach and do in private and face to face  Do in a timely manner- close to the event  Agree the facts  Be specific about the behaviour that needs to be addressed and why this is so  Allow the other party to explain and listen to their point of view  Come to an agreement about what needs to be improved  End on a positive note 18

Feedback conversations RACMA Partnering for Performance 2010 Prepare for the conversation ( both parties involved)  Time/ location/ what to say/ how to say it/ examples to be provided/ relationship to organisational goals etc Ensure positives are covered Look to the future when discussing areas for improvement Focus on the partnership between the parties aimed at providing better care and service delivery Document appropriately 19

Emotional Intelligence and Feedback EQ is the key to both giving and receiving feedback Those who are good at both had a clear insight (Self Awareness) into themselves and demonstrate:  Integrity and honesty (Self Management )  Consideration and concern for others ( Social Awareness)  Valuing differences between people (Relationship Management )  Development of others (Relationship Management )  Optimism (Self Management )  Willingness to set stretch goals (Self Management )  Listening (Social Awareness) RACMA Partnering for Performance

Break RACMA Partnering for Performance

DEVELOPMENT OF DATA FOR GOALS AND POSITION DESCRIPTIONS PERFORMANCE TEMPLATES PRINCIPLES AND PURPOSE OF DOCUMENTATION Session Three: Documenting the feedback process RACMA Partnering for Performance

Examples of data in performance review Goal 1. Prepare written documentation for a common procedure and assess with patients and families 2. Attend a course in communication to improve working relationships with referring practitioners 3. Gain an understanding of the expectations of colleagues who refer patients with a view to contributing to a superlative service Data for assessment 1. Document prepared/ survey of patients and families with changes to document 2. Course attended and review of referring practitioners demonstrates improvement 3. Survey or referrers with action taken on improvements required RACMA Partnering for Performance

Using data for performance assessment Position description criteria: 1. Functions as an integral member of the health services team 2. Contributes to improvement in clinical practice in the unit 3. Documents appropriately in the patient record Assessment criteria examples 1. Attends at least 80% of team meetings/ clear contributor to team meetings 2. Develops improved processes for effective functioning of the unit 3. Audit of patient record demonstrates over 80% compliance with criteria RACMA Partnering for Performance

Using data for performance assessment Assess the provided goals and position descriptions and develop possible data sets that would aid in assessment Work with your group to develop an agreed data set and a means of data collection RACMA Partnering for Performance

Documentation of Conversations Analyse the feedback form provided against the position description  How well does it reflect the PD?  How useful would this be for assessing this position?  How practical would it be in a real- life situation?  What improvements could be made to the template?  How would an informal review be documented? RACMA Partnering for Performance

REVIEW OF CONCERNS DEVELOPMENT OF ACTIONS Session Four: Review and Action plans RACMA Partnering for Performance

Actions Are there still any outstanding concerns?  Discuss these with the group and develop a way to overcome these Write down one action you will undertake in the next 2 weeks as a result of this workshop? RACMA Partnering for Performance