The primary objectives of staff performance evaluations or appraisals are to inform the employee about the quality of their performance, to identify performance gaps and to encourage continued professional growth. Performance appraisals typically include 2 primary components: developing a written performance evaluation and reviewing the performance evaluation with the staff member to provide/receive feedback. 

Frequency of Reviews 

The official performance review should occur at least annually. For new employees, practices should consider reviews at the 90-day or 6-month marks to ensure that the arrangement is still appropriate between employee and practice and to ensure that the employee has a firm grasp on the responsibilities associated with the position. 

While the formal review may occur only annually, direct supervisors and employees often find it beneficial to meet regularly to monitor progress on any areas of concern as well as on any performance objectives that were set during the review process. 

Conducting and Revi​ewing Staff Evaluations/Appraisals 

The employee performance evaluation/appraisal process can be viewed as a 3-phase process: pre-review, review, and post-review.​ 

Pre-Review Phase 
The direct supervisor will complete the performance review based on the template used by the practice. The supervisor may also opt to obtain feedback from other staff members who work closely with the employee. This can be done simply by asking for feedback in an unstructured way, or practices can create a template form. The supervisor can also ask the employee to complete a self-assessment. This self-evaluation can be used by the supervisor to highlight areas of concern or interest to the employee and will help alert the supervisor to any potential differences in how the employee and direct supervisor view the employee's performance during the specific timeframe. 

Review Phase 
This should include an in-person, 2-way conversation between the direct supervisor and employee. Together, during the meeting they will review the performance review itself. Ideally, the employee should have the opportunity to see their review prior to the meeting so questions and comments can be developed and addressed during the meeting rather than after it. 

Post-Review Phase 
Once the meeting has occurred to discuss the performance evaluation/appraisal, the post-review phase begins. The employee should be given a defined period during which the following should occur: 

  • The employee will sign and return the performance review to the direct supervisor. 
  • The employee will develop a draft set of performance objectives for review and approval by the supervisor. 
  • If necessary, action plans will be developed to address any areas of concern (not areas of general professional development possibilities, but significant concerns that are identified through the review process). The action plan should be clear, concise, measurable, and include a definite timeline for each item being addressed so progress can be reviewed appropriately. 

Reviews for Clinical vs Non-Clinical Positions 

While many of the issues addressed in the performance evaluation/appraisal template will be applicable to any employee, there will be some differences for clinical versus non-clinical employees. The duties outlined in the job description should guide the supervisor in terms of evaluating the employee's performance. Direct supervisors should also consider the following:​ 

Clinical Positions 

  • What are the quality improvement initiatives currently underway within the practice? How do these affect clinical outcomes and to what extent is this employee responsible for ensuring certain outcomes are attained? 
  • What data does the practice have to more accurately measure this employee's clinical performance (e.g., data from electronic health record or practice management software)? 
  • To the extent permitted by state and federal law, how independently does the employee function? Is this within the guidelines of the practice? Should the employee be functioning more independently? 
  • Is this employee's documentation of work sufficient (e.g. for coding audits and effective billing to payers)? 

Non-Clinical Positions 

  • Are procedures in place to effectively measure employee performance (e.g., for front desk staff, how long are incoming calls placed on hold)? 
  • Is this employee effectively cross-trained, if required? 
  • How does this employee's performance affect the overall efficiency of the practice’s operations? 

Connecting Performa​nce Evaluations/Appraisals with Pay Increases 

Employers will often connect the results of an employee's annual performance evaluation/appraisal with a pay increase for the year. It is important to clearly outline the procedure for this in the personnel manual and ensure that all employees understand the policy. The practice may decide that, at minimum, each employee will receive a cost-of-living adjustment (COLA) annually, regardless of performance evaluation/appraisal scores. The COLA that will be used should be determined prior to the start of the fiscal year and applied throughout the year. 

The practice can create a tiered system associated with performance for any additional increases it chooses to give. For example, if the practice uses a rating scale of 5 for its evaluation process (e.g., 1, unacceptable performance; 5, exemplary performance), it may choose a percentage increase associated with each rating level. The employee will receive an overall rating and the increase will be associated with that overall score.​ 

Providing regular feedback about staff performance, whether through a structured performance evaluation/appraisal process or informally, is integral to a high performing staff. 

Legal Review of Performance Evaluation Templates 

As with all things related to personnel issues, it may be helpful to have a legal review of all standard templates to ensure that they comply with state and federal laws. Sample Performance Evaluations: 

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American Academy of Pediatrics