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Governing performance. Reexamining the board's role in executive compensation.

If you want a successful organization and you want to keep the IRS off your back, try linking executive performance to compensation. The first step is to develop a philosophy that defines and measures performance in terms of strategic actions. From there, find out how the board should execute what may be its most important responsibility.

Chief Executive Officers, Hospital↗

Compensating the red-circle employee.

Red-circle employees--those who have progressed beyond their pay grade's maximum salary because of merit or tenure--are common in hospitals and represent a challenge to the very purpose of a wage/salary structure. A survey of 18 hospitals in the Southwest indicates five ways in which the problem is currently being handled. 1. Regular increase. In this approach a red-circle employee receives the same increase as if he or she were not at or above the maximum. 2. No increase. No merit-based or seniority pay raise beyond the maximum is allowed with this approach. 3. Limited or minimal increase. Under this policy, only less-than-regular increases are permitted for red-circle personnel. 4. Lump-sum bonus. With this approach eligible employees receive a cash payment "up front" when a rate change is due. 5. No established policy. Red-circle situations are handled on a case-by-case basis, with no set approach. Some red-circle employees receive regular increases; others are given limited pay raises or none at all. The "no increase" strategy ensures that the institution pays only what the job is worth and makes the most sense in the context of a wage/salary structure. This approach may result in the loss of valued personnel, but such turnover can be minimized if the institution provides employees with the encouragement, training, and development opportunities necessary to qualify for higher positions.

Data Collection↗

Performance evaluations of physician executives. Interview by Barbara J. Linney.

Six senior physician executives were interviewed to see how they were doing or not doing performance reviews in their organizations. There seems to be a trend toward doing them, but it is in the beginning stages. Of the physician executives surveyed, the experience ranges from formal lengthy evaluations with rating scales to reviewing a short list of goals. Several are in the process of developing new systems or revising old ones. Probably the most useful part of a performance evaluation is the conversation between the physician executive and the person he or she reports to. If you can stop approaching performance evaluations as passing negative judgments on people, but as having a conversation to hear their concerns, learn what their goals are, and offer ways to help them achieve their potential, they can be useful, enjoyable experiences for both people.

Employee Incentive Plans↗

CEO performance appraisal: review and recommendations.

CEO performance appraisal (PA) is very valuable to an organization, but the chances of obtaining a PA of high quality decrease as executive responsibility increases. The realities of CEO PA are that it: (1) is inevitable; (2) is creative and complex; (3) involves politics; and (4) has a significant effect on the organization and the executive. PA is conducted for legal and social requirements, to enhance communication, to provide opportunities for improvement, and to relate performance to compensation. This article discusses several problems with chief executive officer (CEO) PA and the contemporary approaches that seek to improve it. Three fundamental areas for evaluation are identified: (1) organizational success; (2) areawide health status; and (3) professional role fulfillment. These provide an outline for successful healthcare PA. In addition to a discussion of the strategic considerations behind a successful CEO PA system, several recommendations are offered for the implementation of the annual evaluation process. The final goal of CEO PA is to link its results to CEO incentive compensation. It is strongly recommended that some portion of the CEO's salary directly hinge on his performance in two critical areas: organizational effectiveness and community health status.

Chief Executive Officers, Hospital↗

Practical governance: CEO performance appraisal.

In this excerpt from a book published by the American College of Healthcare Executives, the authors truly live up to the book's title. They present an eminently practical and thorough approach to a significant board responsibility--one designed to ease the difficulty of CEO appraisal while making the process more fair and useful to the board and the CEO.

Chief Executive Officers, Hospital↗

Appraising and paying for performance: another look at an age-old problem.

The basic notion of improving performance through management and appraisal is difficult to successfully implement in practice. These authors discuss some of the problems presented by tying pay to performance appraisals, offer suggestions for improving performance appraisals and outline some other approaches for employers to consider in setting goals and determining compensation.

Conflict, Psychological↗