Affecting Behavior Change, LLC

Performance improvement is always a hot topic; whether you are addressing your own or your employees. 

Feedback is one of the most important consequences in a leader's toolbox.  It lets the employee/staff know what they are doing well and what needs improvement.  How do staff know what to do more of or less of without ongoing communication?  It also solves leaders' problems with ensuring quality staff are hired and maintained.

Here's an example from one of the agencies I consulted with:

The Problem

When I worked with the largest healthcare company in their field in the region, they were having difficulty maintaining quality staff.  Looking at their onboarding process, attendance at orientation was the only requirement for them to move on to next steps.  One of the orientation days for clinical staff required new hires to demonstrate the needed skills to succeed at the company.  The new hires showed their abilities on current patients.  If the supervisor did not feel the new hire demonstrated skills to fluency (fast and accurate over time), the new hire would be placed with a preceptor for additional training.  However, there were no criteria for fading of the preceptor.  The preceptors did not rate if the new hire now had fluency in all needed skill areas.

The Solution

As part of the intervention, with input from the preceptors, supervisors and executive management, we developed a behaviorally anchored rating scale (BARS) for providing feedback to new hires/staff and to make decisions about onboarding and continued employment during their skills day, at the end of preceptor training and for ongoing performance reviews.  We assessed if the new hires/staff performed duties to fluent mastery, if they needed two or less verbal prompts to perform the skill, if they needed supervisor demonstration of the skill or could not perform the skill at all.  This allowed management to determine how long preceptor training was needed or continued, if the staff continued to perform at mastery levels and played a part in performance improvement bonuses.

This was an easy fix to help onboard/maintain quality staff that is still used today within the company.

Using Rating Scales as Part of Staff Feedback to Improve Performance

Feedback without information about performance to back it up is subjective.  One of the easiest ways to objectively provide feedback is to use rating scales as part of performance evaluations.  

To develop BARS, every key task performed by the staff member needs to be known and defined.  Additionally, there needs to be an understanding of all behaviors displayed by individuals that carry out these key tasks. Each behavior is rated and anchored to points on a rating scale, which indicate whether the behavior is extraordinary, fully competent, or unsatisfactory. The result is a rating scale for each task.

For example, in a hypothetical position of housekeeping aide at a hospital, one of the performer's responsibilities is to empty the patient's trash.  The BARS for this task could be ranked as follows:

3 — Extraordinary performance: Empties trash in all rooms and offers greetings and small talk to patients.

2 — Fully competent performance: Empties trash in all rooms and greets patients.

1 — Marginal performance: Empties most trash and ignores patients.

0 — Unsatisfactory performance: Does not perform task or performs less than 75%.

BARS are easy to use. The behavioral indicators make managers and employees aware of expectations.

BARS are objective. The evaluation process is defined and the same for every employee.

BARS are individualized. It promotes consistency within a company.

BARS are action-oriented. Standards of care are known, and staff know what they need to do to improve.

Leave a comment about what specific behavior using a BARS with your staff you would target to improve.