1. CHAPTER 16 Physicians and Health Care Organizations: Achieving Aligned Performance Seminar 9

2. PhysiciansPhysicians Revenue generator Revenue generator Outside normal employment relationship Outside normal employment relationship Individual autonomy Individual autonomy Independent decision making Independent decision making Difficult to integrate into culture Difficult to integrate into culture

3. PhysiciansPhysicians Source of admissions Source of admissions Initiators of ancillary services Initiators of ancillary services Sole source of revenue in a practice Sole source of revenue in a practice Compensate themselves Compensate themselves Clinical and support staff Clinical and support staff Operating expenses Operating expenses Critical to understand physician behavior Critical to understand physician behavior

4. Traditional Roles of Physicians Office-based physicians Office-based physicians Practice owners Practice owners Independent, autonomous professionals Independent, autonomous professionals “Three-legged stool” “Three-legged stool” Clinical autonomy Clinical autonomy

5. New Role of Physicians Shared responsibility for patient care Shared responsibility for patient care Involvement in quality and efficiency improvement Involvement in quality and efficiency improvement Physician accountability Physician accountability Larger physician groups Larger physician groups Reduced reimbursement rates Reduced reimbursement rates

6. Change in Practice Arrangements Medicare payment rates declining Medicare payment rates declining Rising operating expenses Rising operating expenses Increase in volume Increase in volume Ancillary services Ancillary services Mid-level practitioners Mid-level practitioners Movement away from hospitals Movement away from hospitals Hospitalists Hospitalists

7. Physician Populations Three distinct physician populations Three distinct physician populations 1. “Hospital-dependent” physicians 2. “Hospital-independent” physicians 3. “Hospital-irrelevant” physicians

8. “Hospital-Dependent” Physicians Pathology, radiology, anesthesiology, and emergency medicine; hospitalists, intensivists, and neonatologists Pathology, radiology, anesthesiology, and emergency medicine; hospitalists, intensivists, and neonatologists Some employed by hospital Some employed by hospital Strong interest in hospital’s economic success Strong interest in hospital’s economic success Involved in hospital initiatives Involved in hospital initiatives

9. “Hospital-Independent” Physicians Orthopedics, cardiology, otolaryngology, gastroenterology, pulmonary medicine, OBGYN Orthopedics, cardiology, otolaryngology, gastroenterology, pulmonary medicine, OBGYN Office and hospital Office and hospital Privileges at several hospitals Privileges at several hospitals Concerned with efficiency Concerned with efficiency Don’t want to commit extra time to hospital Don’t want to commit extra time to hospital Tenuous “loyalty” Tenuous “loyalty”

10. “Hospital-Irrelevant” Physicians Internists, family physicians, pediatricians, dermatology, psychiatry, allergy Internists, family physicians, pediatricians, dermatology, psychiatry, allergy Rarely provide care in hospitals Rarely provide care in hospitals Little involvement Little involvement Big source of admissions Big source of admissions Significant economic influence Significant economic influence Difficult to engage Difficult to engage

11. Rural Hospitals Rarely more than one hospital Rarely more than one hospital Physicians dependent on hospital’s economic health Physicians dependent on hospital’s economic health Different practice patterns Different practice patterns No option to move elsewhere No option to move elsewhere Mutual dependency Mutual dependency Relationships and communication are key Relationships and communication are key

12. Medical Groups Growing size Growing size Professional practice administrators Professional practice administrators Most are professional corporations (PCs) Most are professional corporations (PCs) Practice autonomously Practice autonomously Access to colleagues Access to colleagues Escalating economic pressures Escalating economic pressures Productivity critical Productivity critical

13. Medical Groups Relative value units (RVUs) Relative value units (RVUs) Gross charges generated Gross charges generated Shared accountability Shared accountability Expectations written in a “compact” Expectations written in a “compact” “I’ll take care of my patients, and the group will run the business” “I’ll take care of my patients, and the group will run the business” Changing demographics of physicians Changing demographics of physicians

14. Future Concerns Emphasis on aligned incentives Emphasis on aligned incentives Hospital acquisition of practices Hospital acquisition of practices Physician-hospital organization (PHO) Physician-hospital organization (PHO) “Bundled” payments “Bundled” payments

15. Management Guidelines Learn as much as possible about the economics of physician practices Learn as much as possible about the economics of physician practices Understand that there may be significantly different economic motives among different groups of physicians Understand that there may be significantly different economic motives among different groups of physicians Look for opportunities to create initiatives that are “win-win” for both physicians and the health care organization Look for opportunities to create initiatives that are “win-win” for both physicians and the health care organization

16. Management Guidelines When launching joint ventures with selected physicians, anticipate and proactively manage opposition from physicians who are not involved in that venture When launching joint ventures with selected physicians, anticipate and proactively manage opposition from physicians who are not involved in that venture Communicate to excess Communicate to excess Develop relationships with administrative leaders of physician groups Develop relationships with administrative leaders of physician groups

17. Staffing Staffing Man Man Legal function concerned with procurement and maintenance of human resources to fulfill the institution’s goals Legal function concerned with procurement and maintenance of human resources to fulfill the institution’s goals Sum of activities needed to attract, develop, and retain people who have the necessary skills and knowledge to achieve departmental objectives Sum of activities needed to attract, develop, and retain people who have the necessary skills and knowledge to achieve departmental objectives

18. Staffing Staffing A component of human resources management A component of human resources management Begins with recruitment and selection Begins with recruitment and selection Recruitment: process of locating qualified candidates Recruitment: process of locating qualified candidates Selection: choosing from the pool of applicants Selection: choosing from the pool of applicants Orienting, placing, training, developing, and compensating subordinates Orienting, placing, training, developing, and compensating subordinates

19. Staffing Management’s duties include judging employees’ work; evaluating their performance; and promoting, rewarding, transferring, disciplining, and discharging them Management’s duties include judging employees’ work; evaluating their performance; and promoting, rewarding, transferring, disciplining, and discharging them Recruitment and initial screening may be performed by the human resources department; final hiring is done by the department supervisor Recruitment and initial screening may be performed by the human resources department; final hiring is done by the department supervisor

20. History of the Human Resources Department History of the Human Resources Department Originally a record-keeping department Originally a record-keeping department Spearheaded activities/functions to thwart unionization in the 1920s Spearheaded activities/functions to thwart unionization in the 1920s Eventually managed the union activities in the 1930s Eventually managed the union activities in the 1930s Became the experts in labor regulations Became the experts in labor regulations Serve as staff experts Serve as staff experts

21. Human Resources Roles in Staffing Human Resources Roles in Staffing Recruiting: fostering community relations, identifying sources of qualified candidates, placing advertisements, and defining benefits and compensation structures Recruiting: fostering community relations, identifying sources of qualified candidates, placing advertisements, and defining benefits and compensation structures Screening: determining whether qualifications match the minimum requirements of the job, conducting testing of applicants, and verifying credentials and past records Screening: determining whether qualifications match the minimum requirements of the job, conducting testing of applicants, and verifying credentials and past records Maintaining records Maintaining records

22. Supervisor’s Role in Staffing Supervisor should Interview, select, and hire from the qualified available candidates Interview, select, and hire from the qualified available candidates Assign the new employee to a specific job Assign the new employee to a specific job Judge how the new employee’s skills can best be used and developed Judge how the new employee’s skills can best be used and developed Orient the employee to the details of the department and job Orient the employee to the details of the department and job

23. Story Time-Hiring Story Time-Hiring What do you think are the optimal qualities for a person wanting to work in a health care agency? What do you think are the optimal qualities for a person wanting to work in a health care agency?

24. Orientation Orientation Make introductions to coworkers Make introductions to coworkers Give department tour Give department tour Define specifics of the job Define specifics of the job Review issues such as safety, security, computer passwords, confidentiality, etc. Review issues such as safety, security, computer passwords, confidentiality, etc.

25. Legal Implications of Human Resource Management Legal Implications of Human Resource Management Federal, state, and local laws, executive orders and guidelines, and court decisions apply to human resources Federal, state, and local laws, executive orders and guidelines, and court decisions apply to human resources Organization policies and procedures must comply with the regulations Organization policies and procedures must comply with the regulations The human resources department assists department managers to consistently comply with the regulations The human resources department assists department managers to consistently comply with the regulations

26. Functional Authority of Human Resources Has final authority for certain actions relative to employee disciplinary actions Has final authority for certain actions relative to employee disciplinary actions Directs/guides the managers in the actions permitted Directs/guides the managers in the actions permitted Uses their expertise in areas that require consistent and equitable human resources practices Uses their expertise in areas that require consistent and equitable human resources practices Maintains and updates job descriptions Maintains and updates job descriptions

27. Functional Authority of Human Resources Maintains the official records of employment Maintains the official records of employment Documents the organization’s compliance with regulations Documents the organization’s compliance with regulations Conducts exit interviews to obtain information to improve managerial practices Conducts exit interviews to obtain information to improve managerial practices Negotiates and ensures compliance with union contracts Negotiates and ensures compliance with union contracts Sets wage ranges and benefit plans Sets wage ranges and benefit plans

28. Defining Staffing Needs Consider existing jobs and functions, assess competencies of current employees, and slot incumbents into the table of positions Consider existing jobs and functions, assess competencies of current employees, and slot incumbents into the table of positions Job descriptions: tell what duties and responsibilities are contained within the job Job descriptions: tell what duties and responsibilities are contained within the job Job specifications: job qualifications Job specifications: job qualifications

29. Story Time- HR Story Time- HR What do you think would be the optimal qualities of a health care human resources professional? What do you think would be the optimal qualities of a health care human resources professional?

30. Job Analysis A study of jobs within the organization A study of jobs within the organization Analyzes the activities the employee performs Analyzes the activities the employee performs Considers the equipment, tools, and work aids the employee uses Considers the equipment, tools, and work aids the employee uses Assesses the work conditions Assesses the work conditions Ascertains the skills necessary to perform the job satisfactorily Ascertains the skills necessary to perform the job satisfactorily

31. Job Descriptions Job Descriptions Should not discriminate against certain classes and must be job related Should not discriminate against certain classes and must be job related Inform the incumbent what he or she is suppose to do, which includes some statement of authority and informational relationships Inform the incumbent what he or she is suppose to do, which includes some statement of authority and informational relationships Should not require skills that are not necessary to perform the job Should not require skills that are not necessary to perform the job

32. Position Titles Not consistent between organizations Not consistent between organizations Same titles may have different meanings in different organizations Same titles may have different meanings in different organizations

33. Staffing Obstacles Staffing Obstacles Baby boomers retiring Baby boomers retiring Younger employees unwilling to accept less desirable shifts/duties Younger employees unwilling to accept less desirable shifts/duties Reduction in workforce available Reduction in workforce available Competency deficits of workforce members Competency deficits of workforce members

34. Story Time-Exodus Story Time-Exodus Many of your staff are quitting or retiring and you losing years of expertise in your staff. What is your plan to fix that? Many of your staff are quitting or retiring and you losing years of expertise in your staff. What is your plan to fix that?

35. Staffing Alternatives Staffing Alternatives Offer internships (paid or unpaid) and cooperative work arrangements Offer internships (paid or unpaid) and cooperative work arrangements Temporary work assignments Temporary work assignments Offer externships: short-term arrangements whereby students observe activities Offer externships: short-term arrangements whereby students observe activities On-the-job training through the use of internal “schools” On-the-job training through the use of internal “schools”

36. Staffing Alternatives Staffing Alternatives Develop in-house temporary services: pool of individuals available to work temporary assignments Develop in-house temporary services: pool of individuals available to work temporary assignments Hire older employees (part-time or full-time) Hire older employees (part-time or full-time) Offer perks and bonuses Offer perks and bonuses Facilitate transfers from another department or job Facilitate transfers from another department or job Should involve human resources department in screening and evaluating candidates applying for transfer Should involve human resources department in screening and evaluating candidates applying for transfer

37. Outsourcing When traditional recruitment efforts are not successful in supplying labor needs When traditional recruitment efforts are not successful in supplying labor needs Outsourcing: contracting a part or an entire function to a third party who supplies appropriate staff Outsourcing: contracting a part or an entire function to a third party who supplies appropriate staff Provides specialized staff Provides specialized staff Allows entity to focus on its core functions Allows entity to focus on its core functions May/may not include retaining existing employees May/may not include retaining existing employees

38. Story Time-Outsource Story Time-Outsource What would be your criterion for deciding to outsource either job functions or clinical duties in the medical office? What would be your criterion for deciding to outsource either job functions or clinical duties in the medical office?

39. The Selection Purpose The Selection Purpose Hiring the best employees available for the organization Hiring the best employees available for the organization Making an investment in your organization Making an investment in your organization Choosing the candidate that best meets the job demands Choosing the candidate that best meets the job demands

40. The Interview The Interview Provides an opportunity for two-way communication Provides an opportunity for two-way communication Provides an opportunity for both parties to learn more about each other and the position Provides an opportunity for both parties to learn more about each other and the position More valid for predicting employee behavior than tests alone More valid for predicting employee behavior than tests alone

41. The Interview The Interview Types: Pre-employment or selection Pre-employment or selection Counseling Counseling Directive Directive Nondirective Nondirective

42. Directive (Structured) Interview Directive (Structured) Interview Conducted when the interviewer knows beforehand the goals, objectives, and areas of discussion Uses a predesigned format Uses a predesigned format Follows a standardized list of questions Follows a standardized list of questions Allows for comparison between interviews Allows for comparison between interviews

43. Nondirective Interview Nondirective Interview Used in counseling situations Used in counseling situations Not necessarily conduct related Not necessarily conduct related No checklist involved No checklist involved Encourages the interviewee to express his or her thoughts freely in order to find out what the interviewee thinks and feels and to obtain opinions Encourages the interviewee to express his or her thoughts freely in order to find out what the interviewee thinks and feels and to obtain opinions Can be time consuming Can be time consuming

44. Employment Interview Employment Interview Also known as the pre-employment or selection interview Also known as the pre-employment or selection interview Is a directive or structured interview Is a directive or structured interview Uses a standardized set of questions Uses a standardized set of questions Re-review the position description Re-review the position description Identify competencies that the candidate may have Identify competencies that the candidate may have Clarify whether the candidate has the necessary skills Clarify whether the candidate has the necessary skills Review the contents of the employment application Review the contents of the employment application

45. Story Time-Interview Story Time-Interview What responses or impressions would most impress you when interviewing potential health care office staff? What responses or impressions would most impress you when interviewing potential health care office staff?

46. Application Form Application Form Used to obtain information about the applicant’s background and present status Used to obtain information about the applicant’s background and present status Education Education Training Training Past and present work experience Past and present work experience Duration of employment and education Duration of employment and education Prior compensation Prior compensation Certain information may not be asked of the applicant Certain information may not be asked of the applicant

47. Scheduling the Interview Scheduling the Interview Interviews can be done via phone or in person Interviews can be done via phone or in person Phone interviews may be conducted in advance of inviting someone to appear in person as a screening approach Phone interviews may be conducted in advance of inviting someone to appear in person as a screening approach Use care in leaving messages Use care in leaving messages Do not conduct the interview while the interviewee is working Do not conduct the interview while the interviewee is working Select a mutually agreeable time Select a mutually agreeable time May involve another supervisor May involve another supervisor

48. The Interview The Interview Conduct it at a time mutually agreeable to give the applicant and manager time to prepare Conduct it at a time mutually agreeable to give the applicant and manager time to prepare Conduct it in a private, quiet location Conduct it in a private, quiet location Avoid interruptions Avoid interruptions Put the applicant at ease Put the applicant at ease Engage in small talk—briefly Engage in small talk—briefly Offer beverage Offer beverage

49. The Interview Outline the job duties Outline the job duties Confirm the individual is capable of performing them Confirm the individual is capable of performing them Physically as well as functionally Physically as well as functionally Permit the applicant to ask questions about the opportunity Permit the applicant to ask questions about the opportunity Avoid any questions that are not directly related to the work to be performed Avoid any questions that are not directly related to the work to be performed

50. Interview Questions Interview Questions Avoid questions that lead to a “yes” or “no” answer Avoid questions that lead to a “yes” or “no” answer Use questions that require the applicant to elaborate on their experiences Use questions that require the applicant to elaborate on their experiences Secure references from the applicant that can speak to the individual’s skills or work experience Secure references from the applicant that can speak to the individual’s skills or work experience

51. Reference Check Reference Check Predefine the questions Predefine the questions Determine how the reference knows the individual Determine how the reference knows the individual Use open-ended questions Use open-ended questions Thank the reference for their input Thank the reference for their input Ask the reference if there is anything else that you should know about the candidate Ask the reference if there is anything else that you should know about the candidate

52. Closing the Interview Closing the Interview Find out if there is anything remaining that the applicant wishes to ask Find out if there is anything remaining that the applicant wishes to ask Share with the applicant when a decision may be made Share with the applicant when a decision may be made

53. Evaluating Candidates Evaluating Candidates Compare notes made during each candidate’s interview Compare notes made during each candidate’s interview Assess which candidate meets the most criteria Assess which candidate meets the most criteria Avoid “over generalization” or “halo effects” Avoid “over generalization” or “halo effects” Avoid trying to have another employee “just like the others in the department” Avoid trying to have another employee “just like the others in the department” Be cautious of candidates who have all the right answers Be cautious of candidates who have all the right answers

54. Using the Team Interview Using the Team Interview Method whereby coworkers interview candidates and determine which one might be the best fit Method whereby coworkers interview candidates and determine which one might be the best fit Does not exempt manager from his or her responsibility of selection Does not exempt manager from his or her responsibility of selection Often improves employee morale Often improves employee morale Often results in the new employee being supported by his or her coworkers Often results in the new employee being supported by his or her coworkers

55. Actions Following the Interview Actions Following the Interview The manager: The manager: Recommend hiring the applicant Recommend hiring the applicant Defer the decision Defer the decision Reject the applicant Reject the applicant Human resources or the manager Human resources or the manager Notify applicants not chosen Notify applicants not chosen Human resources Human resources Perform criminal check of selected applicant(s) Perform criminal check of selected applicant(s) Verify prior employment and credentials Verify prior employment and credentials Inform selected applicant of compensation and orientation date Inform selected applicant of compensation and orientation date

56. Story Time-Uncertainty Story Time-Uncertainty If you had the perfect candidate with all the right qualifications, background and excellent references but the person seemed unsure of themselves and whether they wished to join your organization what would you do? If you had the perfect candidate with all the right qualifications, background and excellent references but the person seemed unsure of themselves and whether they wished to join your organization what would you do?

57. Story Time-Appraisals Story Time-Appraisals Why should we bother with performance appraisals when it is be obvious to the employee if the employer likes the job he\she is doing for the company? Why should we bother with performance appraisals when it is be obvious to the employee if the employer likes the job he\she is doing for the company?

58. Performance Appraisal System Performance Appraisal System An ongoing process of gathering, analyzing, evaluating, and disseminating information about the performance of employees An ongoing process of gathering, analyzing, evaluating, and disseminating information about the performance of employees Important in long-range personnel planning Important in long-range personnel planning Assists the organization in maintaining its productivity and performance goals Assists the organization in maintaining its productivity and performance goals A tool to further the development of employees A tool to further the development of employees

59. Performance Appraisal Performance Appraisal Control system that serves as an audit Control system that serves as an audit Involves decisions regarding: Involves decisions regarding: Continued employment Continued employment Promotion Promotion Demotion Demotion Transfer Transfer Salary increases Salary increases

60. Performance Appraisal Performance Appraisal Used to maximize employee motivation and productivity Used to maximize employee motivation and productivity Identifies additional development required Identifies additional development required Also known as employee evaluation, employee rating, annual review, merit rating Also known as employee evaluation, employee rating, annual review, merit rating

61. Performance Appraisal Methods Performance Appraisal Methods Written essay Written essay Comparative standards: Compare one employee’s performance to the performance of others Comparative standards: Compare one employee’s performance to the performance of others Group ranking: listing employees from highest to lowest Group ranking: listing employees from highest to lowest Paired Comparison: pairing with another and rating one as superior or weaker Paired Comparison: pairing with another and rating one as superior or weaker

62. Performance Appraisal Methods Performance Appraisal Methods Critical Incidents—focusing on certain behaviors Critical Incidents—focusing on certain behaviors Graphic Rating Scale—evaluates the individual’s performance factors Graphic Rating Scale—evaluates the individual’s performance factors Behaviorally Anchored Rating Scale— evaluation combines both behaviors and performance Behaviorally Anchored Rating Scale— evaluation combines both behaviors and performance 360-Degree Feedback—evaluation by peers, superiors, and subordinates 360-Degree Feedback—evaluation by peers, superiors, and subordinates

63. Performance Appraisal Purpose Performance Appraisal Purpose Forces manager to observe and scrutinize his/her subordinates Forces manager to observe and scrutinize his/her subordinates Provides a guide for possible promotion and development, and a basis for merit increases Provides a guide for possible promotion and development, and a basis for merit increases Provides feedback to the individual Provides feedback to the individual Indicates whether the supervisor is succeeding in their job as a coach and teacher Indicates whether the supervisor is succeeding in their job as a coach and teacher

64. Empowerment Empowerment Permits individuals within a work team to make certain decisions about their work assignments, schedules, and other related items Permits individuals within a work team to make certain decisions about their work assignments, schedules, and other related items Is a delegation approach Is a delegation approach May include evaluating peer team members May include evaluating peer team members

65. Story Time-Empowerment Story Time-Empowerment What is your empowerment plan for your employees? What is your empowerment plan for your employees?

66. Skills Inventory Supervisor discusses strengths and weaknesses with the subordinate Supervisor discusses strengths and weaknesses with the subordinate Identifies areas in which the individual needs additional training Identifies areas in which the individual needs additional training Identifies skills or abilities that individual has that may not be specifically needed for his or her job but is beneficial to the organization Identifies skills or abilities that individual has that may not be specifically needed for his or her job but is beneficial to the organization languages languages

67. Timing of Appraisals Should be done regularly—at minimum, annually Should be done regularly—at minimum, annually Ideally, performance will be evaluated several times throughout the year Ideally, performance will be evaluated several times throughout the year Should be done at a time separate from wage adjustment Should be done at a time separate from wage adjustment Does not replace day-to-day coaching and feedback Does not replace day-to-day coaching and feedback

68. The Appraiser Is most often the immediate supervisor Is most often the immediate supervisor May be done in cooperation with the immediate supervisor’s supervisor May be done in cooperation with the immediate supervisor’s supervisor Can be a committee, including peers Can be a committee, including peers Process may include a “self-appraisal” Process may include a “self-appraisal”

69. Performance Rating Use an appraisal form Use an appraisal form Job-related criteria Job-related criteria Special qualities/abilities Special qualities/abilities Avoid the “halo effect” Avoid the “halo effect” Tendency to let the rating assigned to one characteristic influence ratings on other characteristics Tendency to let the rating assigned to one characteristic influence ratings on other characteristics Avoid judging more favorably those employees who share same attitudes as supervisor Avoid judging more favorably those employees who share same attitudes as supervisor Supervisor should be thoroughly prepared to support ratings assigned Supervisor should be thoroughly prepared to support ratings assigned

70. The Appraisal Interview Appraiser meets with the appraisee and discusses the evaluation Appraiser meets with the appraisee and discusses the evaluation Tell-and-sell approach Tell-and-sell approach Tell-and-listen/listen-and-tell approach Tell-and-listen/listen-and-tell approach Problem-solving approach Problem-solving approach Mixed interview (combines all of the above) Mixed interview (combines all of the above) Management by Objectives Management by Objectives Anticipate tension/strain Anticipate tension/strain Keep discussions confidential Keep discussions confidential

71. Appraisal Approaches Tell-and-Sell: supervisor does most of the talking to sell the subordinate on the rating assigned Tell-and-Sell: supervisor does most of the talking to sell the subordinate on the rating assigned Problem-Solving: focuses on certain problem areas Problem-Solving: focuses on certain problem areas Tell-and-Listen/Listen-and-Tell: supervisor tells what he thinks; listens to what the subordinate thinks; then tells subordinate final decision Tell-and-Listen/Listen-and-Tell: supervisor tells what he thinks; listens to what the subordinate thinks; then tells subordinate final decision

72. Management by Objectives Establish objectives in advance Establish objectives in advance Evaluate/rate individuals on their achievement of the objectives Evaluate/rate individuals on their achievement of the objectives Objectives should be identified, measurable, and workable Objectives should be identified, measurable, and workable Objectives should be developed in cooperation with the subordinate Objectives should be developed in cooperation with the subordinate

73. The Appraisal The employee should be allowed to express his or her opinion and provide examples of performance consistent with expectations The employee should be allowed to express his or her opinion and provide examples of performance consistent with expectations Customarily, the evaluation form is signed by both the interviewee and the interviewer Customarily, the evaluation form is signed by both the interviewee and the interviewer May be approved/signed by others May be approved/signed by others

74. Proper Compensation Mixed support for whether the performance evaluation should be conducted at the same time as wage adjustments Mixed support for whether the performance evaluation should be conducted at the same time as wage adjustments The amount of a wage adjustment is in part due to one’s performance, but in part due to the organization’s performance and environmental factors The amount of a wage adjustment is in part due to one’s performance, but in part due to the organization’s performance and environmental factors

75. Story Time-Caring Story Time-Caring Besides money what do you think employees need more of to show you really care about them? Besides money what do you think employees need more of to show you really care about them?

76. Proper Compensation Encourages employees to perform well Encourages employees to perform well Supports the organization’s ability to recruit Supports the organization’s ability to recruit Need to be consistent with external factors (competing organizations) and internally with positions doing comparable work Need to be consistent with external factors (competing organizations) and internally with positions doing comparable work Job evaluation: method of determining the relationship between pay and value of the job Job evaluation: method of determining the relationship between pay and value of the job

77. External Alignment Must be competitive with external organizations that are recruiting the same talent Must be competitive with external organizations that are recruiting the same talent Use surveys to monitor the external environment Use surveys to monitor the external environment Use “benchmark” jobs—positions that have a common title and use across many organizations Use “benchmark” jobs—positions that have a common title and use across many organizations

78. Benefits Vary from organization to organization Vary from organization to organization Common benefits: Common benefits: Pension Pension Insurance Insurance Education reimbursement Education reimbursement Healthcare coverage Healthcare coverage Vacation/paid time off Vacation/paid time off Represent 25% to 35% of the cash payroll Represent 25% to 35% of the cash payroll Determined by human resources and administration; possibly the board of directors Determined by human resources and administration; possibly the board of directors

79. Promotion The reassignment of an individual to a position higher in rank and title The reassignment of an individual to a position higher in rank and title Includes more pay Includes more pay Includes more authority and responsibility Includes more authority and responsibility Includes more privileges, higher status Includes more privileges, higher status Bigger cubicle, parking rights, etc Bigger cubicle, parking rights, etc May include more benefits May include more benefits

80. Promotion from Within Most organizations encourage promotion from within opportunities Most organizations encourage promotion from within opportunities Promotes retention and loyalty to the organization Promotes retention and loyalty to the organization Is less expensive than finding someone and training them from the outside Is less expensive than finding someone and training them from the outside May need “new blood” to bring in new ideas about how to approach processes and problems May need “new blood” to bring in new ideas about how to approach processes and problems

81. Story Time-Within, or Without Story Time-Within, or Without Do you think it is better to promote from within the organization or find the most qualified from with inside or outside the organization for an important job? Do you think it is better to promote from within the organization or find the most qualified from with inside or outside the organization for an important job?

82. Hiring from Outside May be less expensive than training someone from within May be less expensive than training someone from within It is easier to reject an external candidate than an internal candidate It is easier to reject an external candidate than an internal candidate Some internal employees don’t wish to be promoted—they are content with their current position Some internal employees don’t wish to be promoted—they are content with their current position

83. Reasons for Promotion Record of quality performance Record of quality performance High productivity High productivity Skills Skills Ability to work well with others Ability to work well with others Ability to do the job/learn the job Ability to do the job/learn the job Seniority Seniority

84. Line and Staff Authority Relationships Seminar 9

85. Objectives 1. Discuss the need to add staff specialists to the organization. 2. Describe the typical line and staff organization. 3. Describe the primary chain of line command to achieve unity of command. 4. Discuss and contrast line and staff departments and explain their positions in the organizational hierarchy.

86. Objectives 5.Discuss the typical relationship between line and staff. 6.Define functional authority and explain how it is an exception to the typical relationship between line and staff. 7.State the benefits and shortcomings of functional authority.

87. Story Time-Conflict Story Time-Conflict If an employee came into your office and said that she just can not work with another employee one more day because she just can’t stand her, what would you tell the employee, and what would you do? If an employee came into your office and said that she just can not work with another employee one more day because she just can’t stand her, what would you tell the employee, and what would you do?

88. Staff The grouping of individuals together who perform a similar task. The grouping of individuals together who perform a similar task. In management theory, “staff” is a technical term referring to an individual or individuals who serve in an advisory capacity to managers of an organization. In management theory, “staff” is a technical term referring to an individual or individuals who serve in an advisory capacity to managers of an organization. Support managers who lack expertise in certain areas. Support managers who lack expertise in certain areas.

89. Line vs. Staff Staff: Advisory or supportive Staff: Advisory or supportive Line: Direct employees Line: Direct employees Common staff departments: Common staff departments: Human Resources Human Resources Planning Planning Marketing Marketing

90. Line and Staff Within a staff department, there are line roles: Within a staff department, there are line roles: Human resources managers direct the activities of their employees, who advise other department about employee related issues. Human resources managers direct the activities of their employees, who advise other department about employee related issues.

91. Unity of Command vs. Functional Authority Some staff representatives have authority to direct a line manager’s actions (functional authority) Some staff representatives have authority to direct a line manager’s actions (functional authority) Managers may be required to obtain approval from human resources before terminating or counseling an employee Managers may be required to obtain approval from human resources before terminating or counseling an employee In these situations, unity of command is violated—for good reason In these situations, unity of command is violated—for good reason To ensure consistency in employee relations To ensure consistency in employee relations

92. Functional Authority Authority that is granted to a staff member or department to direct certain actions Authority that is granted to a staff member or department to direct certain actions Limited Limited Based on particular staff’s expertise Based on particular staff’s expertise

93. Authority of Medical Staffs May further violate unity of command May further violate unity of command Common scenario in healthcare industry Common scenario in healthcare industry Authority focuses on directing the care of the patient Authority focuses on directing the care of the patient Captain of the Ship: Surgery Captain of the Ship: Surgery

94. Good Night! Good Night! Thank you for attending this seminar. You have all been great students and it has been a pleasure teaching this class! Thank you for attending this seminar. You have all been great students and it has been a pleasure teaching this class!