Employee Performance Improvement and Coaching

Help Employee to Improve Their Performance 

Employee performance improvement can be done by day to day coaching to avoid policy violations.

Day-to-Day Coaching

    Coaching, the day-to-day process of helping employees improve their performance, is an important tool for effective nurse managers. Yet coaching is probably the most difficult task in management and often is neglected. In one short interaction, it encompasses needs analysis, staff development, interviewing, decision making, problem solving, analytical thinking, active listening, motivation, mentoring, and communication skills. 

    Intervening immediately in performance problems on a day-to-day basis usually eliminates small problems before they become larger ones and the subject of discussion in performance appraisal interviews or disciplinary actions. Coaching should also be used when performance meets the standard but improvement can still be obtained.

    The goal of coaching is to eliminate or improve performance problems, but few nurses are prepared to coach and often are hesitant to confront employee problems (Goggin, 2000; Lachman, 2000; Liebowitz, 2003): Coaching employees when the problem initially surfaces: an potentially save time, prevent poor morale from occurring, and avoid later, more difficult action, such as discipline or termination ( Cottringer , 2003; Palermo, 2007). Additionally, appropriate and timely coaching can help retain employees and reduce turnover (Murray, 2003; Stedman & Nolan, 2007).

    Examples of problems that coaching can improve or eliminates are incorrect flow sheet documentation, excessive absenteeism, or frequent personal phone calls. Before entering into a coaching session, the nurse manger (coach) should prepare for the interaction and try to anticipate how the employee will react ("Everybody gets personal phone calls") in order to formulate an appropriate response ("I am here to talk about the number of personal phone calls you receive"). In general, coaching sessions should last no more than 5 to 10 minutes. The steps in successful coaching are

    1. State the targeted performance in behavioral terms. For the past 2 days, the physical assessment portions of your Blow sheets have not been filled out."

  2. Tie the problems to consequences for patient care, the functioning of the organization, or the person's self-interest. "It's difficult for other nurses and physicians to know whether the patient's status is changing, and therefore it's hard to know how to treat the patient. Physical assessments are a standard of practice in our unit. Failure to document assessments could lead to legal problems should the patient's record goes before a court of law." This is an important but often over looked step because it cannot be taken for granted that the employee knows why the behavior is a problem. 

    If employees are expected to act in a certain way, they need to understand why the behavior is important and be rewarded when it has improved. Also, avoid threatening language, such as "If you want to stay in this unit, you had better complete your documentation." This puts the employee on the defensive and makes the person less receptive to change.

    3. Having stated the problem behavior, avoid jumping to conclusions but instead explore reasons for the problem with the employee. Listen openly as the employee describes the problem and the reasons for it. If the problem was caused by ignorance-for instance, lack of familiarity with the standard of care on performing and documenting assessments simply inform the nurse of the appropriate behavior and end the coaching session.

    4. Ask the employee for his or her suggestions and discuss ideas on how to solve the problem. In many cases, the employee knows best how to solve the problem and is more likely to be committed to the solution if it is his or her own. It is better to encourage employees to solve their own problems, but this does not mean that managers cannot add suggestions for improvement. It is essential to listen openly to understand the employee's perspectives

    5.How formal should the coaching session be? If the problem is minor and a first-time occurrence, you may simply state what actions will be taken to solve the problem and end the meeting. In most cases, however, you and the employee should agree on specific behavioral steps each will take to solve the problem; write down these steps for later reference.

    6.Arrange for a follow-up meeting, at which time the employee will receive performance feedback. It is possible that an employee may bring up personal problems as a cause for the work problems. The coaching session then verges on becoming a counseling session. 

    When the employee brings up personal problems, nurse managers should convey their concern and willingness to work with the employee to get help for the problems. In most cases, nurse managers will not be the direct source of the help but rather will help the employee seek out other, more appropriate, sources. Do not delve into potential personal problems ("Are there problems at home that I should know about?") unless staff raise them. The employee's personal life is not the manager's business.

Dealing with a Policy Violation

    As with day-to-day coaching, prepare to confront an employee about a policy violation. The leadership style of the nurse is important in determining whether the employee perceives he or she is being told what to do versus being sold on the idea that she or he is an important contributor to the staff. The steps involved in confrontation are similar to coaching

    The first key behavior is to determine whether the employee is aware of the policy. The employee should have received policy information at orientation, and an up dated policy manual should be readily accessible to all employees. It is also important to know whether the policy has been enforced consistently. If policies regarding tardiness are not applied to everyone on a daily basis, efforts to change this behavior in one individual will predictably be unsuccessful. It is better to identify policies and procedures that the majority of staff accept and to determine which employees need direction in compliance.

    Second, describe the behavior that violated the policy in a manner that conveys concern to the employee regarding the outcome. By focusing on the employee's behavior, you avoid making the interaction a personal issue.

    After stating that the policy has been violated, have documents stating the policy so that interpretation issues can be clarified. For example, if the policy being violated is the requirement that nurses report to a peer about their patients when leaving the unit, have a copy of the policy in hand.

    The next step is to solicit the employee's reason for the behavior (eg, what is preventing the person from informing a peer about patients when leaving the unit). Allow sufficient time for the employee to respond while at the same time guarding against the pursuit of extraneous, unrelated issues. In the latter event, redirect the employee's attention to the policy violation and dealing with other issues at another time. suggest

    Convey to the employee that she or he cannot continue breaking an established policy. In the previous example, you could discuss the effects of the behavior, such as medications not given, IVs running dry, and patients being left unattended, as reasons for the policy.

    Next, explore alternative solutions so that negative outcomes will be avoided. Ask the employee for suggestions for solving the problem, and discuss each of the suggestions. Offer help if it is appropriate. Decide and agree on a course of action. The last step in the process is to set up a reasonable date to follow up with the employee on adherence to the established policy.

    Although dealing with policy violations in a distinct step-by-step sequence is not always possible, proceed in an orderly manner. Many policy violations require early and decisive interventions, and these must be handled in an immediate, forthright manner.