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    « PODCAST: #HRHappyHour 320 - The Business Impact of Learning: A Skillsoft and Florida Blue Case Study | Main | Best practices are not always what they seem: Amazon meeting edition »
    Wednesday
    Apr252018

    The downside of performance transparency

    Openness, transparency, shared and socialized goals - and progress towards attainment of those goals are all generally seen as positive influences on workplaces, organizational culture, and individual performance. We seem to value and appreciate a better understanding of what other folks are working on, how our own projects fit in with the overall organization, and probably more than anything else - we like the idea that performance management, ratings, promotions, and compensation are, above all else, "fair". And when we have that better sense of what people are working on, how much progress is being made, who in the organization is succeeding, (and when we believe the metrics that define success are also clear and visible), it seems logical that it will translate to increased engagement, productivity, and overall positive feelings about work and the organization.

    But, (and you knew there had to be a but), sometimes, openness, transparency, and increased visibility to employee performance and the ability to compare employee performance can drive undesired and even detrimental employee behaviors. And a combination of performance visibility along with the wrong or even misguided employee goals can lead to some really unfortunate outcomes.

    Example: What happened when surgeons in the UK began to me measured primarily on patient mortality and these measurements were made much more visible. 

    From a 2016 piece in the UK Telegraph:

    At least one in three heart surgeons has refused to treat critically ill patients because they are worried it will affect their mortality ratings if things go wrong.

    Patients have been able to see league tables showing how well surgeons perform since 2014.

    But consultant cardiac surgeon Samer Nashef warned that increased transparency had led to doctors gaming the system to avoid poor scores.

    Just under one third of the 115 specialists who responded to Nashef's survey said they had recommended a different treatment path to avoid adding another death to their score. And 84 percent said they were aware of other surgeons doing the same.

    So to re-set - UK surgeons were measured on surgical patient mortality outcomes. These outcomes were highly visible in the industry and by the public. And, as humans always seem to learn really quickly, surgeons began to 'game' the system by increasingly avoiding riskier surgeries for the sickest, neediest patients so as not to negatively impact their own ratings. So the sickest patients, with the most difficult cases found it harder to get the treatment they almost certainly needed. And the best, most talented surgeons, who should have taken up these complex cases, learned to avoid them, or pass them off to other, less talented doctors.

    So the combination of the wrong, or at least imperfect performance metric, (surgical mortality), with the desire (however well-intentioned) to make doctor performance against this imperfect metric more transparent and visible serve to incent the wrong behaviors in doctors, and reduce the overall quality of care to patients - particularly the ones who were in the most dire circumstances.

    The lessons or takeaways from this story?

    Be really careful when making employee performance measurements open and transparent across the organization and beyond.

    Be even more careful if you decide to focus on a single performance metric, that the metric is actually one that is meaningful and relevant to your organization's customers (and isn't one that can be gamed).

    And finally, before you do either of the first two things, you spend some quality time with your organization's best performers to figure out what it is they focus on, how they measure themselves, and how they make sure they are providing the best service possible.

    Chances are, in the UK surgeon case, none of the best surgeons would have said they became great surgeons by avoiding the most difficult cases.

    That's it, I am out - have a great day.

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