A functioning and trained staff is one of the biggest assets and investments of your practice. Your staff’s performance drives your day and your patients’ perception of their office encounter. Setting expectations, providing constructive feedback and using progressive discipline are tools to retain a trained employee rather than searching for a new one.

Developing a detailed job description is a good way to understand the demands and qualifications of each role in the practice. Job descriptions should list the duties of the position, performance expectations, physical requirements and any specialized skills, knowledge or experience needed. Use of the job description can begin at the interview.

The requirements of the position can be used to select potential candidates from a pool of resumes and can be clearly explained to potential employees in the interview process. For example, if the position requires extra hours or has demanding physical requirements, the candidate may choose to decline the offer before they are placed in a situation in which they cannot be successful. Job descriptions are also an important part of managing current employees' performance. Job descriptions should accurately reflect what the employee does in the job and should be updated as needed. If an employer disciplines or terminates an employee for not performing the duties of the position and the duties at issue are not in the job description, the termination will be difficult to defend in the event of a lawsuit.

A new hire orientation program is a good way to set expectations. A thorough orientation checklist will help the employer remember to address all the topics that should be covered with the new employee. In the orientation, the employer should review with the employee items such as the handbook, the job description, and the confidentiality policy. It is advisable to have the employee sign the checklist so there will not be a dispute in the future as to whether certain information or training was covered.

Another way to set expectations for employees is with a handbook. It is not mandatory that companies have a handbook, but there are certain policies that employers should have in place and the handbook is a good way to communicate those policies to the employee. For example, employers with at least fifteen employees should have anti-discrimination and anti-harassment policies, employers with more than fifty employees should have a Family and Medical Leave Act policy and all employers should have a wage and hour policy. Like job descriptions, handbooks should be reviewed and updated regularly to make sure they reflect the actual practices of the company and the most recent law. 

After setting expectations for employees, employers should use periodic evaluations to assess employees and provide feedback about their performance. It is important that evaluators be honest on those evaluations. It will be difficult to defend if an employee is later terminated for performance after a good evaluation.     

It is also a good idea to get input at regular intervals. Many companies evaluate their employees annually, but often the evaluations reflect only what the evaluator can remember of the most recent weeks. One way to get this input is to ask the appropriate persons to complete quarterly surveys about the employee's performance. Keeping a performance log and record when an employee does something well and when they do something poorly is also helpful. The log can help managers prepare an evaluation that is more specific and better covers the entire evaluation period. 

If the employee knows the expectations and fails to meet them, then a progressive discipline plan may be appropriate. A progressive discipline plan should list the expectations that the employee failed to meet and provide an outline of the things that the employee must do to improve. It is helpful to be as specific as possible about what the issues have been and how the employee can correct them.  It is also helpful to set a deadline for completing certain tasks or to set a date to meet again to review the employee's progress.

A progressive discipline plan is a great tool for addressing performance issues, documenting actions taken and ensuring consistency in treatment of employees. A clear and fairly administered progressive discipline policy can be crucial in defending against employment lawsuits. However, the employer should remember that there are some situations where immediate termination may be appropriate. 

In conclusion, setting expectations and managing staff performance will result in positive outcomes for your practice, staff and patients.

Lisa Warren is a healthcare consultant with Warren, Averett, Kimbrough & Marino, LLC. 

Ashley Hattaway is a Partner at Burr & Forman LLP in their labor and employment practice.

This article has been summarized from a segment on ResultsMatterRadio recorded on February 18, 2011. To listen to this segment, and the other segments from the series, "Three Quick HR Tips For Physician Practice Groups", please visit www.resultsmatterradio.com.  .