Feedback & Performance Management

Feedback is essential to fostering a healthy and respectful practice. There are many positive benefits to having effective feedback mechanisms in place. These include increased quality of client care (in response to client feedback), worker cohesion, a stronger ability to attract and retain the best people, and strengthening the practice’s reputation.

Feedback for Midwives

As independent health-care providers, traditional performance management systems are inappropriate for midwives. But peer feedback processes may still be incredibly valuable. The AOM website has samples of processes that practices have used to provide feedback. Be sure to tailor the template(s) to reflect best practices and practice group / community specific info before use.

Practices can ask themselves:

  • what formal or informal mechanisms do they have in place for feedback purposes?
  • What does the workers’ behaviour say (e.g., body language, morale, lateness/absences, willingness to accept more responsibility)?
  • Who do workers currently go to for suggestions, concerns or problems?
  • Is there a lot of turnover or is the practice having difficulty successfully recruiting the best candidates?

If the practice does not currently have feedback systems in place for midwives, a good place to start would be to develop one that works well for the practice size. A regular schedule of small feedback opportunities is usually easier and more effective than a larger, but infrequent plan. For a feedback or performance management system to work it needs to be documented (as a guide and reference). Practices can consider designating someone to take minutes at each practice meeting and distributing those notes, setting aside 10 minutes in each practice meeting to discuss how the practice is doing, or identifying someone to be responsible for asking all workers how they feel they are doing and how the practice could help them.

It can be difficult to know when or how to give feedback when a conflict or problems arise. An excellent way to start is to focus on seeking feedback. For example, the person responsible for having feedback discussions may ask practice members what is working well for them or what their thoughts are on a specific situation. In listening to practice members’ perspectives on a matter, midwives may find a shared perspective that allows for a joint solution or resolution. If they do not share the same perspective, it would still be helpful to have a better understanding of the practice member’s point of view. With this information, the identified individual can take time to plan how best to share feedback that may be difficult to hear.

Performance Management - Employees

A performance review program is a process where each employee’s past work is reviewed and rated against a set of criteria. There are different methodologies as to how the work is reviewed (by a partner, partnership committee, self-evaluated, 360 feedback, or other combinations); on what timeline this review is done (annually or bi-annually are the most common); and against what type of rating scale (simple ‘satisfactory/ unsatisfactory’ to complicated numeric scales).

The first step is to assign someone to supervise these employees who can work together with them to develop objectives for the employee. A designated partner would be responsible for meeting with the employee to review that criteria and those objectives on a set schedule (e.g., quarterly, semi-annually) and set new objectives. The cycle repeats with a continuous series of objectives.

Many organizations develop or modify some type of performance management tool/document that suits their own purposes. There isn’t one perfect performance management program or process. The key to success is to choose or design something that is not overly burdensome to conduct and is valued by the practice. The number one benefit of these types of programs is the conversations they generate. This aspect makes the additional effort to run these programs worthwhile.

See this performance management checklist for tips on implementing such a system.