Care Transformation Center Blog

Do your performance metrics encourage team performance?

by Kate Vonderhaar

It’s no secret health care is a team sport. That’s why I’m surprised by how few frontline performance evaluations include interdisciplinary goals shared by all clinic or unit staff.

Instead, frontline goals are typically based on department performance. Nurses might have a goal to reduce the number of patient falls with injury; pharmacists, the rate of medication errors; and physicians, average length of stay.

But none of these goals can be reached without an interprofessional team. So why aren’t all staff formally held accountable for these goals in performance evaluations?

Where to start

Most leaders I speak with fully support the idea of interdisciplinary team goals, but sharing goals in practice is harder than it might seem at first blush. To make shared goals relevant to all team members (including nurses, physicians, therapists, pharmacists, and non-clinical staff), each department has to compromise.

The one shared goal virtually all department leaders are able to rally around is patient satisfaction. Every employee can impact the patient experience, so several organizations have started including the relevant unit’s or clinic’s patient satisfaction score in staff performance evaluations. Where it gets tricky is moving beyond patient satisfaction to include other elements of team performance.

Bellin Health's interdisciplinary scorecard

Bellin Health in Green Bay, Wis., uses each ambulatory clinic’s scorecard as a proxy for team performance. The performance evaluations of all clinic employees—nurses, medical assistants, front desk staff, radiology and laboratory staff—include the clinic’s scorecard metrics.

The clinic manager assigns points to each metric depending on its end-of-year status: Three points for green metrics, two points for yellow metrics, and one point for red metrics. The sum of the points accounts for one-ninth of an employee’s overall evaluation score.

Physicians are also evaluated on clinic scorecard metrics—the only difference is the metrics carry more weight than in frontline evaluations. Physicians are evaluated on system-level metrics, too, while frontline staff are not.

In addition to patient satisfaction, Bellin’s clinic scorecard includes several quality, financial, and employee engagement metrics.

Too much of a good thing?

While Bellin’s approach moves beyond incenting team performance on a single goal, I worry that many clinic and unit scorecards have too many metrics to incorporate in frontline evaluations.

Four filters for identifying the right performance metrics

Identifying three to five metrics to include may be a more effective way of focusing staff’s attention on a limited set of top priorities. This is especially true if you’re just starting to incorporate goals into frontline evaluations.

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