HealthPartners and American Hospital
Association Partner for National Launch of Joining Forces
HealthPartners Institute for Medical Education and the American Hospital
Association (AHA) have partnered with more than a dozen national
organizations to launch an initiative designed to generate awareness among
medical professionals and others within communities about the challenges --
medical, social and emotional -- that veterans and their families face as
they return home from military service. Through the Joining Forces program
medical professionals will be provided much needed education on dealing with
the medical issues facing our nation’s troops as they return home
from service through a series of online programs.
"Our returning troops have unique medical challenges, which are
sometimes difficult to detect," said Dr. Carl Patow, executive
director of HealthPartners Institute for Medical Education. "This
series sheds light on those conditions so physicians can provide our
returning troops with the best possible care."
HealthPartners first partnered with Twin Cities Public Television, the
Minnesota Army National Guard and Minnesota Department of Veterans Affairs
to create the series in 2007 after learning that many veterans were seeing
their hometown physicians instead of military doctors for treatment after
deployments. After sharing throughout Minnesota,
the groups involved decided to promote nationally in an effort to help
veterans throughout the U.S.
Since that time, the AHA and more than a dozen organizations have signed on
to help spread the word about the program and ensure our returning troops
receive proper care and treatment.
“What began as an effort to educate health caregivers in one
community in Minnesota
about the special needs of returning veterans and their families has grown
into a collaboration among national organizations involving hospitals,
doctors, nurses, social workers, clergy and many others all across our
nation. Like hospitals everywhere, HealthPartners saw a need in their
community and partnered with others to meet that need. And in the best
tradition of community service, they want to make what they did available
to every individual and organization that cares about serving the women and
men who have served our nation in the military. The American Hospital
Association is proud to help make that happen, “said Rich Umbdenstock,
President and Chief Executive Officer, the American Hospital Association.
“One look at the organizations that are coming together to spread the
word about Joining Forces tells an important story about the debt we owe
our troops and the enormous level of support they enjoy back home.”
The four-part series focuses on the most common issues our returning
soldiers face.
The program was based on the award-winning medical conference recognized by
the Alliance
for Continuing Medical Education with the 2008 Award for Outstanding
Collaboration.
Visit www.joiningforcesonline.org for more
information and resources.
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"Defensive Training"
Crain's Detroit Business (09/28/08) Vol. 24, No. 38, P. 11; Ankeny,
Robert
Employers adept at settling employment harassment or discrimination suits
have a difficult time winning against claims of retaliation, say attorneys.
According to the U.S. Equal Employment Opportunity Commission (EEOC),
employment retaliation claims increased by more than 100 percent in the
past 15 years. In 2007, the EEOC received more than 26,600 charges of
retaliation and settled more than 22,250 of them, recouping more than $124
million in charges and other fees. Legal experts indicate firms must train
all workers at all levels about the appropriate ways to handle cases that
could ultimately lead to retaliation claims. Training is necessary given
that many more workers understand their rights and less evidence is
required to prove accusations of retaliation than is necessary in
discrimination liability cases. Attorney Michelle Coakley said she has seen
in many lawsuits that an initial discrimination claim gets dismissed but
the employer nevertheless retaliates against the employee. The key for
employers, Coakley added, is to ensure management-level workers are well
versed in handling employee complaints. Complaints that appear to be valid
should be dealt with by the HR department, and workplace handbooks should
outline anti-retaliation rules so each worker understands what behaviors
are acceptable and what forms must be filled out to file reports.
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"The Right To Refuse: New York Says No to
Mandatory Overtime"
Nurse.com (10/06/08) Sosin, Joan
Beginning in July 2009, nurses in New York will no longer have to choose
between working overtime and losing their jobs thanks to a new law that
eliminates mandatory overtime. Nurses were disciplined for refusing to work
beyond their agreed-upon shifts, and employers contended these actions
amounted to patient abandonment. However, even the new law has exceptions
such that nurses will be required to work overtime during natural
catastrophe or healthcare disasters, during a government-declared state of
emergency, or if their shift ends whilst they are in the midst of a medical
or surgical procedure. However, there also is the emergency situation
exception, which is dictated by employers, though the events can not occur
regularly and good faith efforts to find alternative nursing staff must be
made. Pat Hogan, co-chairwoman of the Public Policy Committee and past
president of the New York Organization of Nurse Executives, says the law is
long overdue and the exceptions are "prudent" and benefit patient
safety. Hogan says hospitals using mandatory overtime most often will
heavily impacted by the new law, but nurse administrators find that the law
could encourage hospitals to offer more funding for additional staff.
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"AARP: Managing the Multigenerational
Workforce"
New Hampshire Business Review (10/10/08) Stone, Tracie
According to the U.S. Bureau of Labor Statistics, nearly 33 percent of the
workforce will by 50 years-old or older by 2014, with the Baby Boomer
generation accounting for 38 percent of the workforce by 2011. Generation X
workers will account for 32 percent of the workforce, Millennials will make
up one-quarter of the workforce, and the World War II generation will still
account for 5 percent of the workforce in 2011. AARP and employers indicate
integrating the skills, philosophies, values, and needs of all four
generations will be difficult. Each generation and their employers must
understand the philosophies and values of each generation in the workforce
in order to satisfy their needs appropriately, according to AARP. Those
employers failing to grasp the differences between the generations and
address them will see hikes in turnover, declines in morale, and an
increase in legal problems. One way to ease the tension is to pair up
younger workers with experienced workers in mentoring and training
programs. "Younger workers may bring new and fresh ideas and can
introduce older workers to new technologies like Facebook while older
workers bring years of experience," says AARP Director of Workforce
Issues Deborah Russell.
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"Cedars-Sinai Program Bridges the MD-RN
Communication Gap"
Nurse.com (10/20/08) Meyers, Susan
Hospitals have until January 2009 to establish codes of conduct for
physicians, nurses and medical staff because The Joint Commission cites
tense relationships among medical workers as detrimental to patient safety
and care. In 2000, Cedars-Sinai Medical Center
in Los Angeles, Calif., implemented the MD-RN
Collaborative to improve communication among physicians and nurses. Since
implementing the program, nurses' and physicians' satisfaction rates rose,
tensions have calmed and healthcare workers are collaborating more readily.
Chris Ng, MD, says, "The nurses are now treated with respect and as
equal partners in care, and this translates into better quality of care."
Other benefits of the program have been improved patient care, increases in
nurse retention and more efficient and patient-centered care. Before the
collaborative, nurses complained about unresponsive physicians and
illegible orders, while physicians questioned nurses' critical thinking
skills. Some of the steps implemented under the collaborative include
placing charts and supplies in the same location in all Cedars-Sinai
hospitals, creating "hot" files at nursing stations for
frequently used order sheets and notes, the use of pre-printed
medical/surgical admission order sets, handwriting classes for physicians,
cell phones for nurses and a standard procedure for handoffs and
discharges. Perhaps the most effective strategy was arranging
nurse-physician rounds where both employees would interact with the patient
together, fostering an unprecedented spirit of collaboration and
understanding.
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"Get Rid of the Performance Review!"
Wall Street Journal (10/20/08) Culbert, Samuel A.
Samuel A. Culbert, a management consultant and professor at the UCLA
Anderson School of Management in Los Angeles, sees seven reasons why
performance reviews should be eliminated: the interests held by the two
participants in a performance examination are in conflict; in reality, pay
is influenced more by market forces and less by performance; performance
"objectivity" is more often than not subjective; making the boss
happy can sometimes overtake good work as the point of a performance review;
admitting her need for improvement, though necessary for receiving
constructive help from a boss, is not what an employee is inclined to do
during a review, thus actual performance is impeded; the performance review
weakens the one-on-one "teamwork" atmosphere; and in many cases
these performance reviews reward dubious behavior instead of corporate
effectiveness. An alternative to the one-sided performance review approach
is a two-sided performance preview. These performance previews focus on
problem-solving and eliminate the need for a boss to rehash actions that
already were committed and cannot be taken back. These include in-depth
discussions about each person's strengths and weaknesses, relying on past
events for demonstrative purposes, and how the participants did or did not
perform well together and alone.
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"Command Performance"
Health Data Management (10/08) Vol. 16, No. 10, P. 50; Anderson, Howard
J.
A number of health insurers are implementing pay-for-performance
initiatives that reward doctors who practice preventive medicine. For
example, the electronic records system used at Sacred Heart
Medical Center
allows doctors to order wellness classes and other preventive measures.
Nurses also submit a list of the patients' at-home drugs to ensure patients
are prescribed the correct medication when discharged. The records system
generates a quality performance report each quarter, using clinical
information to compare the performance of doctors to their peers.
University Health System, San
Antonio, recently implemented a records system
that issues a daily report and automatically alerts doctors when it is time
to order a test. California's
Hills Physicians Medical Group, San Ramon, does not have a full electronic
record program, but has earned incentive payments for its use of data
management software. The software is able to gather and analyze limited
data from a home-grown data warehouse, creating an electronic patient
registry. The Integrated Healthcare Association and Bridges to Excellence
model both offer incentives in exchange for the use of technology. The
Bridges to Excellence model also rewards doctors for meeting goals related
to the treatment of chronically-ill patients.
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"Compensation Counts: How a Holistic View Can
Boost Performance"
Business Performance Management (09/01/08) Vol. 6, No. 3, P. 4; Smith,
Mark
According to research performed by Ventana Research, companies are
considering total compensation management as a way to streamline their
compensation processes because compensation is one of the main motivating
factors for any workforce. According to research conducted on data from
over 300 companies, many companies rely on more than one software solution
to manage the various aspects of compensation, including fixed pay and
performance-based pay. Researchers say the use of spreadsheet software to
keep track of compensation can lead to inefficiency and a loss of
integrity, as well as place compensation information at risk. Some 30
percent of respondents use spreadsheets exclusively for compensation
management, while 39 percent use spreadsheets in conjunction with other
dedicated systems. HR, operations, and finance departments must collaborate
on compensation infrastructure to ensure an efficient process. Ventana
Research recommends that companies first assess their compensation
structure and systems, assess the current compensation management
deployments, and determine the best course of action to improve those
systems. Companies should only replace aging compensation IT systems after
they have agreed upon the necessary parameters for the system. Compensation
systems also must take into account what incentives will work best to
improve employee performance and how those incentives can be incorporated
into the system without negatively impacting the integrity of the system.
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"Legislators Need to Address Big Island Doctor
Shortage"
Honolulu Star-Bulletin (10/08/08)
The Hawaii legislature hopes to address the impending doctor shortage on
the islands in 2009, but many orthopedic surgeons have stated they will
leave the islands in January 2009 as medical malpractice premiums,
malpractice costs, and living expenses skyrocket. These physicians and
others claim the reimbursements from the Hawaii Medical Services
Association and Hawaii Health Systems Corp., which obtains funding from
Medicare, insurers, patients, and state tax revenue, are too low; the
association is expected to run a deficit of $62 million this year alone.
Meanwhile, the state enacted legislation to create a task force to draft
the Hawaii Health Corps Program to stem physician losses on the islands,
but the program is not scheduled for implementation until 2010, and the
state government's hands are tied as its budget shortfalls continue.
Critics contend the situation would be less dire had state lawmakers passed
caps on malpractice suits' noneconomic damage awards.
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"And They're Off! (But Should You Worry?)"
CFO (10/08) Stuart, Alix
While many are concerned that the retirement of baby boomers will lead to a
drastic labor shortage across the country, some say the panic is unfounded.
"There's nothing to this story about a national labor shortage.
Despite the impending retirement bubble, the labor force will continue to
grow in absolute numbers over the coming decades, albeit at a slightly
slower rate than in past years. The real issue is a talent shortage, not a
labor shortage. What's new is that companies haven't taken the time to
develop talent," says Peter Cappelli, a professor at the University of Pennsylvania's
Wharton School and author of the book
"Talent on Demand." Companies can head off a potential labor
shortage or talent shortage by crunching the hiring and retention numbers,
which chief financial officers can use to run a cost-benefit analyses to
determine which workers should be retained. PSEG, a New Jersey-based utility,
examined its talent pipeline and discovered many of its workers stay on
past retirement age. The utility also took the time to work with area
community colleges to develop courses to train students in specific skill
sets. The program has helped PSEG hire 66 new workers in the last several
years, which is on pace with the number of retirements the utility
experiences. Human capital planning can go a long way, say experts, because
it provides employers with information on the average age of workers within
specific roles, facilities, or geographies and historical retirement
patterns.
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"Go Green: Three R's of Conservation Apply to
HR/Benefits"
Employee Benefit News (10/08) Vol. 22, No. 13, P. 15; Glinsky, Kim
A slogan long-used to combat waste and encourage conservation--reduce,
reuse, and recycle--also can transmit valuable lessons for HR leaders in
establishing a vibrant and stable workforce. For HR and benefits
professionals, these three R's are reduce turnover through training; reuse
talent through redeployment and career advancement; and recycle employees,
especially Baby Boomers. Studies show that workers in their 20s and 30s are
more likely to leave a job that they find unfulfilling or unchallenging.
Training and career development programs mitigate this loss by expanding
the employee's skill set, allowing the worker to feel challenged and eager
to advance within the company, and increasing employee productivity while
reducing turnover. HR departments can save on hiring costs and utilize a
worker's untapped talents by identifying a career path, suggesting
opportunities to enhance individual skills, and applying the power of
redeployment. Methods for retaining the valuable knowledge of retiring baby
boomers include providing alternative work opportunities, starting programs
to help older workers explore retirement options that still allow
involvement with the company, and fostering an atmosphere of diversity in
cultures, talents, skills, and backgrounds.
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"Graceful Exits"
Claims (10/08) Vol. 56, No. 10, P. 14; Quinley, Kevin
An employer misses out on a valuable source of inside intelligence when it
fails to follow up on an employee's announced departure with an exit
interview. Exit interviews should not be conducted by the departing
employee's supervisor, but by a trained HR professional who will conduct
the interview in a dispassionate and professional way. Instead of a
face-to-face interview, an organization may choose to send a mail-in
questionnaire, as employees sometimes feel more honest on paper and
generally workers are not in the proper frame of mind on their last day to
provide clear answers or helpful feedback. If an employer still wishes to
conduct a face-to-face meeting with a departing worker, it should be done
several days prior to their departure. If during exit interviews employers
notice recurring themes, such as pay or management concerns, employers
would do well to cull insights and use them to improve retention and
employee morale through various improvements ranging from pay raises,
workload modifications, or discussions with offending supervisors. HR
professionals must write down verbatim what employees say to prevent any
memory lapses or incongruities. Feedback should then be examined and used
to determine what actions, if any, should be taken.
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"Balancing a Holistic Approach to Benefits"
Risk & Insurance (10/08) Vol. 19, No. 13, P. 25
To effectively deal with the rising costs of employee healthcare coverage
and lost productivity, companies must integrate medical, disability, and
behavioral health benefits into a holistically to ensure benefits programs
perform efficiently, discourage presenteeism, and reduce the number of
disability claims that account for a vast amount of healthcare
expenditures. According to the Integrated Benefits Institute, the costs of
absenteeism as a result of disability exceed all other medical and
disability payments combined. Because 10 percent of disability claims
account for more than 50 percent of all disability and medical spending, a
program that combines disease identification for at-risk employees early on
can reduce the costs of lost productivity as well as future healthcare
costs related to disease management. The most recent Watson Wyatt
Staying@Work Report notes that companies with
"high-effectiveness" health & productivity (H&P) programs
are several times more likely than companies with low-effectiveness H&P
programs to realize lower long-term disability, short-term disability, and
general medical coverage costs. A coordinated medical, disability, or
workers' compensation program could identify possible areas of remediation
to help employees already debilitated by disease or surgery readjust to the
workplace. For example, the program could recommend a diet and health plan
for an overweight employee who is considering surgery as a solution to
recurring back pain. A proactive partnership not only keeps the employee
healthy and productive, it also reduces the employer's costs for
unnecessary medical services.
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"Benefits: Adult Education"
CFO (10/08) Vol. 24, No. 9, P. 59; Hyatt, Josh
Employers must create tools that engage workers in their own benefits
programs, enabling them to learn about the variety of benefits offered and
to make the best decisions for their retirement, healthcare, and other
needs. Moreover, these interactive tools can improve worker productivity,
morale, and retention rates. A recent Emerging Workforce Study conducted by
Harris Interactive on behalf of Spherion Corp. reveals that 78 percent of
the 3,152 polled employees named benefits as a slightly more important
retention tool than compensation, which received 75 percent of the votes.
Experts suggest that benefits can provide workers peace of mind, which
makes them happier and more productive. Experts agree that providing
workers with personalized benefits statements that outline the "hidden
value" of noncash benefits can improve morale and generate loyalty
among workers. However, Aon Consulting recently discovered that fewer than
50 percent of companies believe that communicating total compensation is
worthwhile. The use of Internet or intranet sites to provide benefits
updates to workers are gaining ground, but employees are now demanding more
detail and answers to their specific questions, requiring companies to
devise strategies to meet workers' education needs. Some firms offer
podcasts and emails about bits of benefits information, while others are
holding seminars for specific demographics to answer pointed questions. The
Pension Protection Act of 2006 also enables employers to automatically sign
up workers for corporate retirement plans and allows workers to have access
to financial advisors. Employers are urged to remain flexible as new
benefits emerge and demands among workers for education and other
arrangement evolve.
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"Employee Benefits Review"
Mondaq (09/17/08) Maher, Peter
Although organizations may feel the pressure to lower salaries due to the
ongoing financial turmoil, it is important that they prevent excessive
employee turnover. Organizations can reduce their costs and enhance their
employee benefits packages to keep their workforce happy, and one option to
lower costs and enhance benefits is through voluntary offerings such as
life insurance or dental insurance. Although these plans require employers
to keep accurate records of each member's chosen benefits, employers with
flexible benefits are more attractive to employees. Employers can easily
determine which benefits are the best to offer their workforce through an
employee survey. These surveys also serve as a reminder to workers how
valuable their benefits are, which experts say can prevent turnover.
Difficult market conditions require employers to ensure the happiness of
managers who will become the catalysts that help navigate the organization
through an economic downturn.
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"Study: Weight Surgery Pays off for
Employers"
Workforce Management (10/08) Smerd, Jeremy
According to a recent study published in the American Journal of Managed
Care, employers benefit from paying for workers' bariatric surgeries within
2 years to 4 years, even though the surgical procedure can cost up to
$25,000. The study followed more than 3,000 patients for up to five years
after their bariatric procedures, and researchers examined whether those
procedures reduced overall medical costs compared to similar scenarios in
which patients were treated with medication alone. Researchers concluded
that bariatric surgery is a cost-effective investment that can transform
the health of workers and save employers money in the long term. These
workers experienced reduced risks for diabetes, heart disease, and
depression. Those employers concerned about the risks of the surgery should
educate themselves about the minimally invasive microscopy procedures
available, which have reduced risks and costs for patients and payors.
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"Quality Update: Reaching Out to
Physicians"
Trustee (10/08) Vol. 61, No. 9, P. 28; Lindberg, Laura; Paller, Debbie
Many healthcare facilities now see the value of opening up solid lines of
communication with physicians. Hospital administrators must strike a
balance with physicians between their needs as customers and their needs as
employees in the hospital planning process. There are several important
elements to a strong physician-hospital relationship including planning for
the future, flexibility, responsiveness to concerns, confidence, and trust.
To foster these goals, hospitals should start by reserving a certain number
of positions on the board of directors and on important hospital committees
for physicians. Executives also should establish open communication with
physicians. For example, at MidState
Medical Center
in Meriden, Conn., the hospitals CEO, COO, and the
director of medical affairs have a working lunch each week with top medical
staff, and the medical staff have invited the CEO, the COO, and other board
members to participate in staff meetings. Other helpful strategies for
physician communications include same-day callback policies, personal
primary care office visits, and involving physicians in the hospital's
strategic planning process.
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"Hospitalists and Care Transitions: The Divorce
of Inpatient and Outpatient Care"
Health Affairs (Quarter 4, 2008) Vol. 27, No. 5, P. 1315; Pham, Hoangmai
H.; Grossman, Joy M.; Cohen, Genna
As part of the Community Tracking Study (CTS), researchers interviewed 352
local healthcare leaders, including CEOs, CFOs and CMOs of major hospitals
in 12 metropolitan areas. One of the major trends discovered during these
interviews was the rapidly increasing number of hospitalists employed by
healthcare facilities. Executives at 34 of the 36 hospitals reported growth
in the number of hospitalists practicing at their facilities during the
past two years or in the percentage of general medicine admissions treated
by hospitalists. Currently, hospitalists in at least one hospital already
treat 50 percent or more of general medicine admissions in nine out of the
12 markets identified by CTS. Hospital executives report a number of
motivations for expanding hospitalist services, including attracting and
retaining high-revenue admitters, increasing referral rates, and
facilitating the integration of information technology into workflows.
Despite these advantages, the growing use of hospitalists also presents
several challenges, particularly by creating a division between hospital
medicine and community-based physicians. This division can cause admission
disruptions and increase care coordination burdens for all providers. To
alleviate this problem, hospitals have instituted a number of policies
designed to improve care coordination, but these facilities must have audit
and warning systems in place to ensure policies are carried out.
Additionally, experts recommend instituting programs designed to ensure
provider accountability and adequate physician supply.
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Management and Leadership
"10 Ways to Initiate and Manage Change
Effectively"
Washington SmartCEO (10/08) Vol. 3, No. 10, P. 12; Strouse, Douglas;
Wexley, Kenneth
The establishment and management of strategic change requires a specific
style of leadership, and consultants Kenneth Wexley and Douglas Strouse
cite envisioning, energizing, and enabling as the three key leadership
attributes identified by authors David Nadler and Michael Tushman as
essential to effective organization change management. Wexley and Strouse
emphasize that a good leader makes sure that the right people get "on
the bus," and ensuring this requires rigorous upfront assessment of
candidates and a willingness to change personnel without hesitation when a
problem is clearly perceived. Employees must have the proper motivation to
desire change, so leaders have to proactively "champion" the
necessary changes by calling meetings of all workers affected by the change
where they can express their worries and concerns, and by touching base
with employees periodically throughout the change process. Leaders should
also extend their leadership to others during the change process, and make
an effort to eliminate casual comments that can kill creativity and make
the culture less welcoming of change. Opposition to change is natural and
must be addressed, while leaders should be committed to coaxing the
organization to embrace technological advances. Appropriate organizational
structures, systems, and policies must be implemented to ensure successful
change management, and the Successful Manager's Handbook suggests that
leaders should draw up a roster of current structures, systems, and
policies to determine which should be kept, enhanced, or eliminated, as
well as inquire how such elements could be created from the ground up to
support a new vision. Vigilance must be practiced following change
deployment to prevent reversion, and preventive measures include close
follow-up while remedial measures in event of relapse include recognition
of successes and the provision of refresher training. Finally, Wexley and
Strouse say that a leader must ensure that every member of the organization
is following the same path through constant cultural evaluation and the
implementation of feedback systems.
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"Evaluating the CEO"
Harvard Business Review (10/08) Vol. 86, No. 10, P. 53; Kaufman, Stephen
Top executives' performances are typically reviewed based upon their unit's
financial performance, unlike other employees whose performance evaluations
take into account those workers' abilities to work with others and meet
targets. Former Arrow Electronics CEO Stephen P. Kaufman says boards need
to establish an evaluation process that goes beyond merely justifying
compensation committee decisions about incentives and pay packages. Board
members should meet with executives in less structured settings more than
once per year; for instance, Arrow had independent board members meet with
three executives and discuss company strategy, culture, competitive
position, financials, and operations. Once directors, usually on a rotating
basis, met with the executives they would then meet with the rest of the
board to discuss what they learned from the meetings before the board met
to determine executive pay and address other organization-related issues.
If any directors raised similar issues, it was flagged for the compensation
committee to discuss, along with a short self-assessment authored by the
CEO. After the review was finalized, the CEO met with the compensation
committee for approximately two hours, and about seven days later the CEO
would follow up with a memo to committee members about the items discussed.
This process can not only help CEOs recognize their own flaws, but also can
alert the board to underlying problems that would not be revealed from a
simple analysis of corporate financial performance.
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