6Most HR professionals agree that it’s important for employees to have well-articulated goals to guide their work. However, goals alone are not enough. Healthcare organizations have discovered that providing employees with mentoring and coaching, in conjunction with goals, leads to greater employee accountability and better on-the-job performance.

Performance management is only effective if it’s a continuous process, rather than a once a year conversation at evaluation time. Healthcare leaders like Phelps County Regional Medical Center in Rolla, Missouri and Union Hospital in Terre Haute, Indiana have developed a variety of coaching and mentoring programs that increase the touch points between managers and employees. These initiatives help improve retention among high performing team members, increase employee satisfaction through more targeted professional development, and enhance employee accountability by combining goals with frequent feedback.

Two years ago, Phelps County Regional Medical Center (PCRMC) launched its C3 Conversations program. This is a structured communication process that creates a bridge between formal performance evaluations and the ad hoc, immediate feedback that is provided through “managing by wandering around.” Twice a year, managers are asked to hold fifteen to twenty minute C3 Conversations with every employee. The C3 term refers to discussions targeted at three levels of performance: Commitment conversations occur with high performers, Coach conversations occur with middle performers, and Counsel conversations occur with low performers.

The C3 program promotes transparency about performance expectations for both managers and employees. To support the initiative, the Human Resources team created a clear set of criteria which define whether a staff member is considered a high, middle, or low performer. The criteria have proven to be beneficial in several ways:

  • Managers use a consistent approach to coaching. With the criteria, supervisors know what to look for, as they evaluate employee performance and every manager is working from the same set of standards.
  • Employees have insight into how they are evaluated. Team members understand how their work is assessed. All employees have access to a C3 Frequently Asked Questions Document on the organization’s intranet. Using the same criteria across departments makes it less likely that employees will claim they have been unfairly treated.
  • The criteria can be incorporated into management tools. Managers have access to a spreadsheet that includes the C3 criteria. Supervisors can enter employee names, evaluate performance against the criteria, and determine which type of conversation is most appropriate for each team member.

C3 conversations ensure that managers are open with every staff member about their performance. “These are two-way conversations,” said Frank Lazzaro, III, Administrative Director, Human Resources at Phelps County Regional Medical Center. “Employees like to know where they stand and learn how they can improve. It’s also important for management to keep abreast of how employees are doing.”

An effective C3 conversation includes observations about employee performance, feedback about changes that individuals can make in order to do their jobs better, and questions for employees. Managers at PCRMC are encouraged to use the following tips:

  1. Prepare in advance. Supervisors understand that it’s important to prepare for these discussions ahead of time. Often this includes gathering feedback from an employee’s peers. Some managers use PCRMC’s performance management system to capture this feedback.
  1. Structure the conversation in four parts. The HR team recommends that managers structure C3 conversations in four parts. First, the supervisor emphasizes that PCRMC values the employee and wants to retain them. Next, the supervisor conveys that he or she wants to support the employee. Third, the manager engages in coaching and suggests ways that the staff member could be more effective on the job. Finally, the supervisor closes the conversation by reiterating that PCRMC is committed to supporting the employee.
  1. Sequence the conversations by performance level. In addition to guidance on how to structure C3 conversations, the HR department also advises managers to talk first with employees in the Commitment level, followed by those in the Coach group, and then conclude with the team members in the Counsel category.

At PCRMC, managers engage in employee rounding. Many supervisors have found that the C3 program is a useful tool for customizing their interactions with staff members as they do rounds. When managers explain to employees how their performance is improving, it helps create an emotional “bank account” and promotes greater trust among teams. “We feel that C3 conversations complement our performance management process. They don’t replace formal evaluations, but these discussions help correct poor performance, sustain good performance, and increase performance levels overall within the organization,” said Lazzaro.

Similar to PCRMC, Union Hospital has also developed an approach to mentoring and coaching that benefits employees at all levels of the organization. Union Hospital has a formal goal setting process which ensures that department and employee goals are aligned with broader organizational objectives. The performance management system contains Union Hospital’s critical success factors and twelve institutional goals. As departments establish their goals, they must align with the organizational objectives and employee goals must align with departmental goals. “Goal setting in conjunction with coaching has really helped with employee accountability,” said Joanne Davignon, Director of HR at Union Hospital. “Employees know from the first day on the job what is expected of them and they receive continual feedback.”

By engaging in coaching, managers promote a more open dialogue about performance and development issues. When employees talk about where they see themselves professionally in three years, it enables supervisors to establish goals which will help employees build the competencies they’ll need to attain those goals. A “goals check-in” process helps team members stay focused on what they need to achieve. Union Hospital’s performance management system sends reminders to managers to reach out to employees periodically about their work. Both employees and managers can enter information into the system, as well, which helps track progress toward goals.

In addition to goals setting and coaching, Union Hospital has several mentoring initiatives that are targeted at different employee groups. New hires in clinical areas participate in a preceptor program. “Employees are assigned a primary and a secondary preceptor. With this approach, team members are always assured of a timely response to their questions. This has a positive impact on employee satisfaction and it reduces first year turnover among new hires,” said Davignon.

However, new hires are not the only employee group that can benefit from mentoring. Union Hospital launched the “Leaders on the Horizon” program to coach and cultivate organizational leaders. The initiative addresses three tiers of leaders: emerging leaders, operational leaders, and strategic leaders. To identify the areas where leaders could benefit from additional development, the HR team is planning to have program participants complete an online behavioral assessment. Union Hospital uses this type of tool in recruiting, but the leadership development program appears to be another useful application for it. “The assessment feedback report is so useful. Based on that information, leaders can create an action plan for improving their effectiveness. In addition, we plan to assign mentors who can help these individuals reach their development goals,” said Davignon. The assessment reports also identify eLearning courses and books that would be helpful for different development areas. Based on resources recommended by the assessment system, Union Hospital is considering creation of a lending library and book group to support Leaders on the Horizon participants.

While managers often have a lot of experience coaching and mentoring, it can be harder for individual contributors to develop these skills. To address this challenge, Union Hospital has developed an innovative approach. At any given time, there are over 600 college students doing internships at Union Hospital. Frontline employees are given an opportunity to mentor the capstone students. This benefits the organization in two ways. Employees at the staff level gain experience with coaching and mentoring. It also demonstrates to students that the hospital is interested in their performance and development. New graduates are an important source of new talent and the employee mentoring program differentiates Union Hospital as a great place to work.

Performance management is an ongoing process that should be top of mind all year around. Mentoring and coaching programs are an effective way to provide continuous feedback to frontline employees, managers, and leaders. These techniques bridge the gap between formal, point in time evaluations and help team members focus on ways they can improve their performance on the job. The results include better patient care, greater employee accountability and satisfaction, as well as lower turnover among the strongest performers.

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Note: This post originally appeared on HR.com’s Talent Management Excellence Essentials ePublication. 

About Ratan Tavawala

Ratan Tavawala is a Senior Solutions Consultant at HealthcareSource and has been with the company for nearly 10 years. Prior to her move to Sales, Ratan was the Manager for Implementation Services and helped build a strong team of Specialists while implementing HealthcareSource products at hundreds of healthcare facilities. Ratan is now focused on ensuring she can lend her expertise to healthcare clients in evaluating their talent management needs while also lending her knowledge in getting such systems in place. Ratan is an avid reader and is currently enjoying The Power of One by Bryce Courtenay.