Sheba Vine

Healthcare providers faced with poor employee performance have several options in terms of disciplinary measures, depending on whether the provider has a progressive discipline policy that must be followed. Different forms of discipline may include counseling, verbal warnings, written warnings, demotion, suspension, probation, and termination.

One effective corrective action tool providers can utilize to address situations of continuing performance deficiencies involves closely monitoring and measuring performance by placing an employee on a performance improvement plan (PIP). The PIP serves to improve employee job performance within a specified period of time with the understanding that unsatisfactory performance will be met with remedial action. The use of a PIP must be made on a case by case basis as it may not be appropriate in all circumstances.

If a PIP is warranted, it is important for the provider to clearly communicate its expectations to the employee. A clearly defined written PIP will include the following key elements:

• Provide justification for placing the employee on a PIP by identifying performance deficiencies in detail;

• Create a plan of action by setting specific goals to be completed while on the PIP that relate to the employee's performance deficiencies and how the goals will be measured;

• Set a timeframe for the PIP to end, whereby the employee is required to complete all goals successfully in order to be removed from the PIP and continue employment;

• State that remedial action will be taken if PIP is not successfully completed;

• Schedule recurring meetings within the PIP timeframe in order to evaluate employee progress against the PIP goals and document such progress and feedback.

Importance of Setting Realistic PIP Goals 

The goals set out in the PIP should be realistic and align with the employee's job responsibilities. Be careful not to assign tasks that are unattainable and outside the regular scope of duties, as this can lead to potential liability for the provider - the PIP is not a means to set up the employee for failure. And in meeting the specified goals, the employee should be given any necessary support, resources or additional training.

At the conclusion of the PIP, the provider must take appropriate action consistent with the employee's performance. The provider may choose to extend the timeframe of the PIP if it is evident that the employee is making meaningful attempts to meet the PIP's goals and improve overall performance. If the employee has successfully completed all PIP goals, the PIP must be closed out and the employee allowed to continue employment with the expectation that the satisfactory performance will continue. On the other hand, prompt and appropriate remedial action should be taken if the employee has failed to perform adequately and meet the expectations of the PIP at its expiration. If used properly, an effective PIP can open lines of communication, improve employee attitude, increase productivity and create a healthier working environment in the long-run.

Sheba E. Vine, Esq., CPCO, is the Senior Director of Regulatory Compliance at First Healthcare Compliance, a company that offers a comprehensive "turnkey" compliance program management solution to healthcare providers and others involved in managing healthcare compliance. Ms. Vine has practiced as a litigation and employment attorney and received her Juris Doctorate from Widener University School of Law and her Bachelor of Science in Biomedical Engineering from Drexel University.

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Do you have a staff member that is under-performing? Use a performance improvement plan to get them back on track.