HCS 475 Week 4 Performance Indicators for Staff and Organizational Goals Example

Eight Numbers on One Page and a Conversation Every Month: Performance Indicators for an Imaging Department and Its Technologists, Linked to the Hospital's Goals

[Student Name]

University of Phoenix

HCS/475: Leadership and Performance Development

Week 4 Assignment

[Instructor Name]

[Date]

The imaging department, its measures and its baselines are composites written for a model paper; frameworks and research come from the sources listed.

When the new imaging director at a composite 320-bed hospital opened the department's performance dashboard, she found 34 measures on four pages, updated monthly by an analyst and read, as far as anyone could tell, by no one. Technologists received a performance rating once a year on a form that scored attitude, teamwork and reliability from one to five. Neither the dashboard nor the form told anyone whether the department was helping the hospital reach its goals. This paper describes how she rebuilt both.

Starting From the Hospital's Goals

The hospital's strategic plan named four goals: safe, timely care; an excellent patient experience; a stable workforce; and financial sustainability. The director asked of each: which few imaging measures would show whether we are contributing? Ittner and Larcker (2003) warned that organizations often choose nonfinancial measures without testing whether they drive results, and she applied that caution by asking, for each candidate indicator, what action it would prompt.

The Balanced Scorecard

Kaplan and Norton (1992) proposed the balanced scorecard to give leaders a quick but complete view of performance through four lenses: money, the customer's view, the internal processes that must excel and the organization's ability to improve and learn. The director adapted the perspectives to patient, process, people and finance, so no single perspective could dominate the others.

The Eight Department Indicators

Patient: outpatient patient experience score, baseline 78th percentile, target 85th; share of outpatients scanned within 15 minutes of appointment time, baseline 71%, target 85%. Process: emergency department CT report turnaround within 60 minutes, baseline 82%, target 92%; repeat radiographs as a share of all radiographs, baseline 4.1%, target 3.0%. People: annual technologist turnover, baseline 17%, target 10%; staff engagement score, baseline 3.6 of 5, target 4.0. Finance: cost per exam adjusted for exam mix, target a 3% reduction; outpatient MRI access in days to the third available appointment, baseline 19, target 7.

What She Dropped

Several popular measures were removed. Exams per technologist hour was dropped as an individual measure because it rewarded rushing and penalized technologists assigned to complex patients or interventional cases. Total exam volume was dropped from the scorecard because volume depends on referrals the department does not control. Patient complaints counted in raw numbers were replaced by the experience score, which adjusts for volume.

Unintended Consequences

Every indicator can be gamed. A turnaround target can tempt staff to mark an exam complete before images are sent; the department defined completion by the time images reach the radiologist's worklist. A repeat rate target can tempt technologists to accept poor images; radiologists audit a sample of accepted images monthly. An indicator that can be met without improving care will, sooner or later, be met that way.

From Department to Individual

Each department goal was translated into expectations individual technologists control. For timeliness: starting scans on time when patients are ready and communicating delays to the front desk. For quality: personal repeat rate, reviewed privately. For patient experience: comments naming the technologist, positive or negative. For people: completing required competencies and mentoring a new hire when asked. Measures outside a technologist's control, such as scanner downtime, are reported at the department level only.

Why the Annual Form Went

Kluger and DeNisi (1996) pooled studies of feedback given at work and in laboratories and reported a surprise: although the average effect was positive, in over a third of comparisons people performed worse after feedback, most often when the message shifted their attention from the job to themselves. The annual form did exactly that: it rated attitude and reliability, arrived once a year and often surprised staff. The director replaced it with a monthly 15-minute conversation between each technologist and a supervisor, focused on the individual measures, specific examples and one goal for the next month.

Involving Technologists in the Design

The director did not build the indicators alone. She asked each modality to nominate a technologist to a small design group that reviewed the draft scorecard. The group changed two measures: it asked that on-time starts exclude delays caused by late patient arrivals, which technologists cannot control, and it proposed that positive patient comments be shared at monthly huddles. Involving staff took three extra weeks but made the indicators feel like the department's measures rather than management's, and the design group now reviews the scorecard each year.

Supervisors' Role

Modality supervisors received training in giving specific, task-focused feedback and in coaching rather than judging. The director reviews a sample of conversation notes each quarter to check that they focus on behavior and goals. Supervisors also practice difficult conversations in pairs, such as telling a respected senior technologist that her repeat rate has risen, because the hardest feedback is often owed to the most experienced staff.

Reporting

The eight indicators fit on one page, updated monthly and posted in each modality's workroom. The director reviews them with supervisors monthly and with the hospital's executive team quarterly.

Early Results After Six Months

On-time starts rose from 71% to 80%, emergency CT turnaround within 60 minutes from 82% to 89% and the repeat rate fell to 3.4%. Turnover in the first six months ran at an annualized 12%. Staff engagement will be measured again at year end. Two indicators, cost per exam and MRI access, had not yet moved, which the director expected because both depend on the staffing plan still under way.

Lessons

Fewer indicators produced more attention. Linking individual expectations to what staff control reduced complaints about fairness. And the monthly conversation, not the scorecard, is where performance changed.

Conclusion

Rebuilding performance measurement began with the hospital's goals, not the available data. Eight indicators across four perspectives, each with a definition, baseline and target, show the department's contribution; individual measures limited to what technologists control connect their work to those goals. Research on feedback explains why frequent, task-focused conversations replaced the annual form, and early results suggest the combination is working.

References

Ittner, C. D., & Larcker, D. F. (2003). Coming up short on nonfinancial performance measurement. Harvard Business Review, 81(11), 88-95.

Kaplan, R. S., & Norton, D. P. (1992). The balanced scorecard: Measures that drive performance. Harvard Business Review, 70(1), 71-79.

Kluger, A. N., & DeNisi, A. (1996). The effects of feedback interventions on performance: A historical review, a meta-analysis, and a preliminary feedback intervention theory. Psychological Bulletin, 119(2), 254-284. https://doi.org/10.1037/0033-2909.119.2.254