When it comes time to promote from within, managers will often look back at their most recent stack of performance evaluations to begin brainstorming candidates. Staff members who get stellar reviews just naturally stand out from the crowd.
How can you make sure you’re among them? These managers explain what they’re looking for during these sessions, and why.
Mary Lou Guy, MBA, RRT, says she uses the performance evaluation to look for behavior-based information.
“I provide staff a list of job-related expectations that essentially revolve around discipline/accountability, engagement/learning, and communication skills/safety,” said the pulmonary services manager at Saint Luke’s North Hospital in Kansas City, MO. “These also support the core values of our system.”
She’s particularly interested in measurable traits that allow her to gauge improvement/decline over time in each of her RTs. When it comes to clinical skills the evaluation begins by determining whether the therapist attended the initial training, then progresses to questions regarding his/her ability to retain the learning without direct supervision.
“This is measurable by observation of the skill/knowledge during work or by practice sessions performed by the staff member,” Guy said. ”We have practice scenarios developed for a number of processes, and staff either on their own or in groups can pull the scenarios/supplies and practice the skill/knowledge.”
For example, in the area of NICU care, therapists must spend 15 minutes per pay period practicing their ability to set up a ventilator and give surfactant — two skills they rarely perform but must nevertheless maintain competency in.
Guy uses the performance evaluation to track time and attendance, goal setting, and the maintenance of mandatory processes such as license, competencies, and certifications, along with other factors, as well. “These demonstrate discipline, teamwork, resource management, customer focus, and quality, and are the direct result of a person’s behaviors,” she said.
Keeping it positive
At Baptist Health Paducah in Paducah, KY, Pam Lindemann, MA, RRT, NHDP-BC, says she uses the performance evaluation to provide positive feedback to her RTs.
“Performance evaluations are not the time to sit and drag on a list of criticisms and tear the employee down,” said the director of respiratory care, neurodiagnostics, and sleep. “It is a time to celebrate the greatness that the employee has accomplished over the year and make some suggestions for improvement if need be.”
She believes the positive approach is best, even when an employee needs remedial action.
“It is the time to apply some ‘Miracle Grow’ to an employee that may need some assistance,” Lindemann said.
Her key areas of focus are collaboration and teamwork, quality of work, and attendance and reliability.
“We are in every department of the hospital,” she said of the first. “It is crucial that we get along with all of them and assist them when we can and each other. We never know when we may need assistance as well and need to lean on them.”
In terms of quality of work, she wants to ensure her RTs don’t cut corners and that they share their knowledge with patients to help them stay out of the hospital. She believes that mindset not only reflects high-quality work but also demonstrates pride in the profession.
“If we show pride, we will be given the respect that we need,” Lindemann said.
Judging attendance and reliability is vital to success in the other two areas.
“Knowing that each person will show up, not only in person but in reliability, is a colossal hurdle for the team,” she said. “When teams know this about each other, they are strong and a force to be reckoned with.”
Three traits top his list
Jack Fried, MS, BSRC, RRT, director of respiratory care and neurodiagnostic services at St. Mark’s Hospital in Salt Lake City, UT, looks at a slew of things during performance evaluations, but three basic traits stand out from the crowd.
First and foremost, he tries to gauge if the employee in question is being the teammate his/her coworker’s trust and value.
“This is, to me, the most important of the 30 categories rated in our department,” Fried said. “There are reasons people want to work with certain individuals and not work with others. People want to work with others on whom they can depend on for help, people who come to work on time and when scheduled, people who are upbeat and pleasant, people who get the work done without complaining even when staffing is less than optimal, and people with good clinical skills.”
This leads to the next trait on his list, which is the demonstration of professional heavier in actions and the consistent portrayal of positive behavior.
“There are times, in the middle of a shift or even at the beginning, when you need another therapist, or maybe even two, but no one else is available to work,” Fried said. “What happens to the patients if you lose your composure and panic?”
He says many times RTs will push forward on their own and everything will be fine, but other times the therapist may end up drowning in calls, even though other clinicians still need him to be at his best.
The third point that matters most to Fried is the RT’s ability to serve the needs of others with compassion. He notes that means not just patients and families, but the other clinicians RTs work with daily as well.
“Let’s not forget the nurse who has been struggling with a deteriorating patient for hours and who now needs support. Let’s not forget a physician whose patient has suffered a complication. Let’s not forget a colleague who suddenly bursts into tears because of problems at home,” he said. “The need for kindness, concern, and empathy applies to everyone.”
Soft skills matter
Performance evaluations at OCH-Regional Medical Center in Starkville, MS, have migrated away from clinical competencies to focus more on the soft skills RTs need to deliver quality care.
“Accreditation and other legislations mandate competency of skills, and therapists that lack minimal skillsets, or fail to demonstrate appropriate skills, are coached, counseled, and corrected accordingly at the time when the failure mode is noted or observed,” said Wes Andrews, MA, RRT, CHEP, director of respiratory care services and disaster preparedness officer. “Our performance appraisal has less to do with skillsets and more to do with how the therapist integrates value in the performance of a skill.”
He believes strongly that reinforcing the value component enables his staff to be seen by others in the facility as essential to patient care.
“By reinforcing the value of the service/therapy provided, our staff can still be the subject-matter-expert and engage the patient, rather than just recite facts and do neb therapy,” Andrews said.
Centered around behaviors
John Campbell, MA, MBA, RRT, RRT-NPS, RPFT, FACHE, believes performance evaluations should be centered around behaviors rather than attitudes because the latter simply can’t be measured.
“I like to bring measurements to these evaluations as much as possible,” said the pulmonary services director at St. Dominic-Jackson Memorial Hospital in Jackson, MS. “This includes setting measurable individual and group performance goals, such as hitting quality indicators or advancing education and credentials.”
He also looks at the RT’s record of specific, observed performance in patient care — good and bad — because as a manager, that’s something he doesn’t always have a chance to witness for himself.
Soft skills that are important to him include taking the initiative and being self-motivated.
“This includes patient care, customer satisfaction, and just seeing a problem where the staff member owns it and fixes it,” Campbell said. “In a 24/7 operation, I must depend on individuals to perform well all of the time. Many patient care and customer issues cannot and should not wait for management to step in.”
He believes RTs who demonstrate the ability for self-motivation and can take the initiative to fix things that are wrong have the type of decision-making skills he is looking for in his department.
“This is an extremely valuable individual to management,” Campbell said.
Top three questions
Long-time manager and management consultant Garry Kauffman, MPA, RRT, FAARC, FACHE, believes performance evaluations can include the kind of questions managers often include during job interviews as well.
His top three —
- Tell me about a time when you made a mistake. What did you do as a result?
- Tell me about a time when you had a disagreement with a colleague (e.g. physician, nurse, RT). Without naming names, what was the issue, what was the position of the other person, what was your position based on, and how was it resolved.
- Tell me about a time when you had to deal with a colleague who just wasn’t committed to giving her/his best. How did you frame the conversation, how did the RT respond, and what was the result?
“The ‘mistake’ question is the one they dread, but it tells me whether they are honest or not,” Kauffman said. “Plus, I tell them that admitting a mistake never hurts their evaluation.”
After all, everyone makes mistakes, and those who can admit to them are often those who are best able to learn from them.
Attitude, reliability, and interpersonal skills
Clearly, RT managers believe strongly in the value of the performance evaluation, and the RTs who work for them should not only take these annual sessions seriously but also strive toward the types of behaviors managers are looking for on a day to day basis.
Duke Johns isn’t an RT but he is an honorary member of the AARC who owns and operates a home care company in New Orleans, LA, that employs therapists. His advice is short and sweet, but it echoes that stated by the managers in this story.
According to Johns, it’s all about attitude, reliability, and interpersonal skills. Therapists who demonstrate proficiency in those characteristics are the therapists he wants on the job.