Guest Column: How to appraise your teamwork performance
By Patrice Spath, RHIT
Brown-Spath & Associates
Forest Grove, OR
Teamwork is an important component of case management. Case managers must closely collaborate with other caregivers and providers as well as other members of the case management department. It is sometimes difficult to separate individual contributions from those of other people involved in patient care activities. A department director who only measures and recognizes individual performance may find that teamwork is jeopardized because it appears to be ignored. By measuring an individual’s team performance, you can promote personnel development and also focus staff on achieving collaboration goals. The director and case management staff can use the performance appraisal process to:
- plan departmental, individual performance;
- set individual goals that are aligned with departmental goals;
- establish performance expectations;
- measure actual departmental and individual performance against desired performance;
- determine staff developmental and training needs;
- provide feedback on performance;
- provide a basis for recognizing departmental and individual performance.
It is possible to measure performance of work done by an individual and also evaluate that person’s contribution to the patient care team. For example, a process measure of an employee’s team contribution might include whether or how well the case manager cooperates with other caregivers. The accuracy of information supplied to other care team members by the case manager is an example of an outcome measure.
Case managers can be appraised on how well they work with care team members. Examples of measures used to evaluate "team-supportive" behaviors could include the degree to which the case manager:
- participates in patient care team meetings;
- volunteers for patient care improvement projects;
- communicates with members in a constructive and nonthreatening manner;
- is perceived by other caregivers as pleasant to work with and cooperative.
Case managers must have good interpersonal skills. This behavior contributes to effective care team performance but can be difficult to evaluate objectively. Here are example criteria for evaluation purposes to assess interpersonal skills:
Employee meets standard
- with few exceptions, interacts effectively, tactfully, and cooperatively with all levels of the organization;
- routinely expresses support for the value of diverse opinions;
- routinely establishes rapport in initial contacts with others at all levels;
- routinely gains support for ideas or suggestions through effective negotiation skills;
- spends sufficient time cultivating contacts with caregivers and providers to get timely information or resolve issues outside formal channels;
- routinely keeps care team members, patients, families, and other appropriate parties informed of significant patient care developments.
Employee exceeds standard
Meets above criteria plus:
- consistently wins the support and confidence of others in one-on-one and group situations;
- presents positions with force and diplomacy, achieving agreement despite initial opposition;
- handles confrontations and hostile reactions calmly, in a way that defuses the situation.
The behavior standards for case managers should describe conduct that can be reasonably measured and controlled at the employee’s level. Such behaviors represent the case manager’s contributions to the care team’s activities. The results of case management activities that contribute to overall patient outcomes can be assessed and verified. Examples of measures to assess a case manager’s work results include:
- ratio of correct to incorrect recommendations;
- timeliness of the employee’s interventions;
- number of patient care improvement suggestions made by employee;
- accuracy of the information the employee provided to the team.
Here are examples of criteria to evaluate the case manager’s ability to give professional advice and recommendations — an important team supportive skill for case managers.
Employee meets standard
- provides expert advice to other health care team members that usually is accurate and timely;
- provides advice that usually is meaningful and contributes to the success of the patient care experience.
Employee exceeds standard
Meets above criteria plus:
- Advice contains innovative approaches and solutions to patient care problems.
- Improved accomplishment of patient care goals results from employee’s unusual initiative and accomplished case management expertise.
- Patients, families, and other caregivers seek out employee for advice and expertise.
- Employee voluntarily completes a significant amount of additional work or special assignments.
The importance of team performance can be emphasized through the creation of appropriate rewards. When standards are measurable and achievable, the case management department may wish to establish incentives that are awarded to employees who help achieve teamwork goals.
Working well together
The case management department also can be appraised on its internal group processes to judge the level of teamwork within the department. Work assignments and performance measures could include how well:
- case managers work together as a group;
- departmental meetings are planned and run, and if they’re on time;
- case managers reach consensus on departmental issues;
- case managers use problem-solving techniques to improve internal process.
Clearly defined roles for employees are important to the teamwork of the case management department.
The following criteria can be used to evaluate this attribute:
- Everyone in the department understands his or her duties and knows who is responsible for specific issues and tasks.
- Everyone has the skills needed to accomplish his or her responsibilities.
- Everyone understands which roles belong to one person and which are shared.
- The talents of all employees are valued and all are involved in departmental activities so that no one feels left out or taken advantage of.
The case management department should regularly measure individual and group team performance to assess teamwork contributions.
Teamwork measurements are valuable performance management tools that help in clarifying individual, team, and departmental goals and keep everyone pointed in the right direction. Such efforts support and produce better collaboration within the department and among caregivers.
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