THERE are many types of veterinary practices, ranging from those that are managed by a single vet to those that are part of large veterinary groups with several branches and numerous veterinary surgeons in each of them.
The biggest mistake made by the average clinical manager is to base the appraisal solely on economic parameters. It is an easy way to know how a vet is doing, mainly because most of the common veterinary programs will give you the figures straight away. For example, data on number of visits, average spent per visit, etc., can be easily calculated.
In some veterinary clinics the veterinary surgeon is required to sell a certain number of worming or flea treatments per period, otherwise the performance is considered poor. In reality, however, this is not informative enough to properly assess somebody’s true performance.
An appraisal can be defined as a two-way discussion of past and present experiences and achievements at work and using this as the basis for agreeing future development to the benefit of the organisation and the employee. The aim of the appraisal is to facilitate development, motivate and improve performance.
An appraisal needs to cover all practice staff including vets, nurses and receptionists and range from medical and surgical abilities for some to client satisfaction for all. This has to be more than a five minute job at the end of the month to tell the vet that he or she is not selling enough food, as is quite often the case.
The results obtained during the appraisal should not be used to punish the staff member but to help his or her personal professional development. This means that if during the appraisal we find that a certain vet is not confident in the use of the endoscope, our proactive approach should be to train and assist him, rather than establish that endoscopy will not be booked in with that vet.
The performance review should avoid matters such as salary, discipline, promotions and staff induction as they should have their own protocols and more appropriate timings.
Now we have established some of the reasons to have this appraisal, we will talk about the procedure itself. The protocol should be standardised and applicable to all members of staff, regardless of their role.
The questions should be non-specific, such as, “Are you confident discussing procedures with the clients?” This can then be applied to vets relating to surgical technique, nurses regarding after-care and receptionists regarding period of hospitalisation and likely costs/insurance claims, for example.
Once the protocol has been developed by the management team, one or more of them should be assigned to perform the review of all the members of staff. This person/s need to be senior in the practice for reasons of respect and to demonstrate the importance of the procedure. It is also important that they are objective and do not have any personal issues within the team.
Prior to the appraisal, a copy of the protocol format should have been forwarded to the employees for them to review prior to the meeting. This allows staff members time to consider their responses to questions that may be asked and also be mindful of any relevant points they may like to raise with the manager/s.
At the time of the meeting, both parties need to exchange what they have in their notes and have a candid approach to the discussion to achieve an improvement.
A good way to prepare the protocol is to divide the questions into blocks. I think that the following five blocks can cover all the areas reasonably efficiently. On the other hand, we can add as many blocks and questions as we want to tailor the process to a specific practice but we must be aware of the goals of the questions and not allow the meeting to become an interrogation.
- Personal appearance and time-keeping.
Here we would have questions relating to uniform cleanliness, personal hygiene, arriving on time and leaving on time – it is very common to berate employees for arriving late, but we must also appreciate those extra 15 minutes they stay after leaving time when consults run late.
- Appropriate knowledge
This area would cover the general knowledge of the different protocols of the practice (health and safety standardised procedures, etc.). For example: “Do you know what to do in case of a fire?”, “Do you know who is responsible for first aid?” It will also cover aspects regarding the specific role of each person. These questions need to be presented in a positive way and always clarify the constructive intention of them. A good example could be: “How do you rate your knowledge of the duties given to you in your job description?”
- Abilities
This group of questions is based on the abilities needed for each specific role, from registering a new client (for the receptionists), changing IV fluid bags (for a nurse) to performing routine surgery (for a vet). This can be a tricky group as the employee may need to demonstrate these skills by being shadowed by the person performing the appraisal or by interviewing colleagues in direct contact with the employee. However, it is worthwhile doing if there is any doubt that tasks are not being completed competently.
- Team work
This set of questions is aimed to measure how well integrated a person is in the team and how well he or she interacts with the other members of staff. It is vital for a healthy environment to find disturbances in the dynamics of the team as soon as they happen. If there is friction between two members of staff or if anybody is feeling isolated, we must act quickly as leaders. We cannot rely on gossip as a source of information but need to investigate unrest and also leave the impression that the “door is always open” for staff to approach senior members directly with issues.
- Information and personal professional development
In this final group, questions are designed to establish if the courses attended are money well invested. Questions like, “How happy are you with your CPD hours?” or “How much do you use the topics learnt at your CPD?”, are essential to establish if we are investing well in people or they are just attending courses because it is compulsory. Equally, we must make note of any courses that have been beneficial and worth other members attending in the future.
Scoring
Answers are then simply scored from 1 to 5, where 1 is considered the furthest from the ideal response and 5 the closest. Then the average is calculated per block and in total. There should also be a blank space for notes to be used by both people involved in the process. This allows a more interactive process.
It is essential to find the areas with discrepancies and find solutions for them. Of course, it is important to spend time with those with lower scores but also to highlight and praise those people who have scored well.
Issues should be addressed in a second meeting, allowing plenty of time for discussion and guidance. It must be a constructive meeting and not an exchange of accusations. The appraisal is an active process, which means that it is not just a meeting to talk, shake hands and “see you next year”, but is vital to have an action plan at the end of it and follow that through.
During the post-appraisal discussion, a lot of information will be shared. The action plan is a working document, which enables both parties to agree what the employee will do over the next 12 months (courses, practical sessions, etc.). The action plan is the formal record of the appraisal.
As the discussion progresses and actions are planned, the person under review should make a note of the aims and objectives. He or she has to agree that those actions are needed and fair. As always, it is easier to do more of what you want to do than something that you feel less confident in. Agreement should also be reached on a realistic time-scale for their completion. It may be a good idea to agree and record dates for follow-up review meetings.
- Job specific
These relate to the way that the individual carries out his or her current job and should build on success and address specific current development needs.
- Quality improvement
The aim always has to be the excellence in every aspect of the job, so everybody has room for improvement.
- Developmental
These look beyond the job that the individual is currently doing. The goal is to grow into the practice and have more responsibility.
At the end of the appraisal the manager should write up the action plan, take a copy and give the original to the employee. The plan should be agreed within a few days and finally both parties should sign and date the document.
It is important for practices to appreciate the value of the appraisal system both in terms of immediate practice improvement but also the medium and long term benefits of cost-efficiency that come with improved client service, staff retention and improved skill sets.
