Sydney Outpatient Rehabilitation is a small outpatient care facility located in Tocoma, WA. This is an on-site rehab facility that treats adults 18 and over who have recently had surgery or have been referred by their physician for Physical, Occupational or Speech therapy services. It was founded in 1981 by Ernest Tisdale II, who was inspired by the death of his mother, Abigail. He found that the one-hour commute to take her to a large hospital rehab facility was very taxing on both of them.
The companys mission is to deliver superior care that improves the quality of life of every patient and setting the standard by which other outpatient rehabs are rated. Today, it is one of the oldest community-based outpatient rehab center and recognized for top quality standards within the state of Washington. Sydney leaders know that its staff is a big reason for the organizations success and having skilled employees and helping them attain their personal and professional goals while delivering excellent patient care, provides the best results.
There 16 full-time and 2 prn therapists including the Director of Rehab and an office administrator. They are a close-knit group and all work together to provide the best treatment outcomes for the patient. During the past 4 years, and in line with the facilitys mission, upper management has been making some organizational changes to retain staff and increase productivity.
The Rehab Director, Anthony, practices an open-door policy for staff grievances, feedback and suggestions. He considers them as his second family and everyone is comfortable around him. He knows they do not follow the rules all the time or handle situations that come up in the most professional way, but he believes overall, everything works out eventually. Recently, he has been hearing rumors about performance evaluations and issues with productivity goals. He has some idea where the frustrations are coming from but not sure what are the specific concerns regarding performance evaluations. He decides to address their worries in next months staff meeting.
Today, Anthony will be completing two performance evaluations, scheduled for 8am and 11am. He asks the office administrator to print out a couple of progress notes from each therapists discharged list, productivity reports and timesheets for him to review later. He remembers that he has to cut a piece of Thera-band, so he heads off to the storage closet. In the rehab gym, he notices that Barbaras patient is sitting quietly. After inquiring, the patient says she has been waiting for Barbara for about 10 minutes now. Not long after, Barbara comes rushing in and hurriedly gathers supplies to start the treatment session. Anthony then heads back to his office to meet with Suzie for her performance evaluation. He realizes that he did not get a chance to review her paperwork, so he takes a minute to glance over it.
Everything looks ok, youve been here about 3 ? years now and all your patients rave about you. Your progress notes are still lacking skilled elements though; didnt we discuss that the last time? Yes, Suzie replies but you told me you were going to help but you did not get back to me, so Ive been just doing my best. Well, you should have gotten back to me and it is your license on the line not mine. He looks over some other papers and then asks her if she has any questions. He writes and circles a few things on her evaluation and slides it over to her to review and sign. As she gets to the end of the sheet, she notices that she received no raise and immediately feels frustrated but does not say anything to Anthony. She tells him she has no questions, signs the evaluation and leaves the office.
Heading to the bathroom to freshen up, many thoughts are going through her head. She thinks how unfair it is that she didnt get a raise just because her documentation is not the best. Also, how confused she is about the whole evaluation process. Meanwhile, Anthony goes about his day as usual, checking off his list and feeling very productive. Its now 10:40am, so he decides to be a little bit more prepared for his next evaluation, with Barbara. He looks first at her progress notes and hes not surprised because her notes are exceptional, well-documented and meets medically necessary standards. He turns his attention to her time sheet, attendance record and productivity report. She has called out of work 3 times in the last month, tardy 2-3 times a week and she has not been meeting her productivity goals for the last 2 months. He is taken aback that he hadnt noticed this before.
At that moment, he sees Barbara, right on time for their meeting. Hi, Barbara, have a seat and well get started. First, thank you for your commitment to efficient documentation, keep up the great work. I do see some things here that Im concerned about though. You called out 3 times last month, your constantly tardy and you havent met the daily productivity goal of 85% in a couple weeks. Whats going on Barbara? Anthony, you know I have to make sure mom is ok before I leave in the morning and those days that I called out, I couldnt find anyone to take her to the doctor. Ok, Anthony says but it is not a good look when your patient is waiting on you for 10 minutes, its just not professional and only further drives down your productivity. Anyway, lets finish up. He takes a couple minutes to write a few sentences then slides the paper to Barbara to review.
As she reads, he sees her face getting red. Any questions? Anthony asks. Yes, I just dont understand why I only got 50 cents raise. I try to help as much as I can around here, you said my notes are great and Im not the only one who isnt meeting their productivity goals she exclaims. I just dont think its fair, I thought I was doing everything I could to get the full increase, I guess I was wrong. Anthony struggles to give a satisfactory answer which angers her even more. Visibly annoyed, she thanks him and leaves. Anthony starts to wonder how the other staff feels about the performance evaluations. After pondering for a while, he decides he needs to get back to the basics. He knows there has got to be a better way of approaching performance evaluations. The next morning, he calls Peter the COO, to discuss some changes hed like to implement in the next few weeks. Later that day, he announces that at the next meeting that he will be rolling out some new changes regarding performance evaluations and productivity standards and would welcome any suggestions or feedback from them.
Anthony receives quite a few suggestions on both issues and decides to incorporate some of them into the upcoming changes. During the next few weeks he puts together a plan with input from the staff and feedback from Peter. He now understands that he is a big influence on the facilitys culture and as the manager he must intentionally shape and influence this culture so that its in line with the companys mission and goals. He also learns that an effective evaluation process is a key factor in a companys success, so he develops a new standardized approach to performance evaluations. Elements will include employee participation and sets of competences that have been approved by the staff. Finally, he will offer ways to improve productivity levels.
At the beginning of the meeting, Anthony thanks everyone for their dedication to the patients and providing superior patient outcomes. He then explains that the new changes will help with the daily workflow and increase everyones productivity. He goes on to explain in detail the following changes:
1. Each therapist must arrive at least 5 minutes before the start of the patients appointment
2. A guide on calculating productivity and improving time management skills will be posted
3. Implementing a 360-degree performance evaluation that includes reports on productivity, progress notes, attendance and specific feedback from co-workers
4. Implementing one-on-one training and corrective action plans to promote professional development and personal accountability
It has been about 2 ? months since the new changes were introduced, and Anthony has noticed the impact they have made. It hasnt been without its challenges because not many will welcome change. But, he was able to overcome them by meeting one-on-one with each person, offer additional clarification on things they were unclear about and allowing them to voice their concerns. Therapists were more intentional in their work performance because now it is linked directly to a raise and that made them more accountable. There was a 30% decrease in tardiness and 22% increase in average productivity. The online documentation training that Suzie took part in has really helped and most of her progress notes contains all the medically necessary elements.
The biggest improvement, by far, is how well the 360-degree evaluations have been working out. Based on the feedback he received, Anthony realized that the previous evaluations were subjective, and the staff only had vague ideas about what deciding factors impacted their raise. The surveys he received back gave him constructive responses that he was able to use as a factor in the employee evaluation. Each element was assigned certain points and once the overall score was tallied, the percentage increase was based on that score. Everyone thought that was fair and now they knew exactly what they needed to do in order get a great review.
With everyones cooperation, Anthony was able to change the culture of this small facility overtime. He realized what a big influence he had on his staff and the general morale. He used this influence to get everyone aligned with the companys mission. Most importantly, he learned that an effective leader uses all the resources and tools available to motivate and propel those around them to achieve their personal and professional goals.