In earlier days when it was time for Main Line Health to do an employee's appraisal, human resources (HR) staff had to pull the person's files and then shuffle mounds of paper to achieve an adequate appraisal. Often information was missing, delaying the appraisal because no one knew who was working on which aspect of the appraisal. It was a huge headache.

Today, at the Bryn Mawr, Pa.-based health system, the HR staff has all of the information they need at their fingertips to begin and follow an appraisal through to on-time completion.

Main Line Health is now using Halogen Software's eAppraisal Healthcare tool. The health system, which operates and manages four hospitals, a home health network, physician practices, lab services and a research facility, uses the software to streamline its extensive employee appraisal process, reduce paperwork and filing, and better align with Joint Commission accreditation requirements.

Appraisal tool

"The software gives us a specialized appraisal tool that our managers need to develop professional-quality, medical-based appraisals," Eileen McAnally, senior vice president of HR at Main Line Health, said. "It's easy to use and implement while giving us everything we need to meet the changing Joint Commission accreditation criteria. As part of our initiative to be an employer of choice in the region, receiving quality feedback on employee performance is essential."

The health system began its selection process in 2005 and sent a request for proposal (RFP) to six appraisal software vendors. The health system's IT department, working with the HR department, drafted the RFP for the system. The health system was looking for a vendor that would allow it to run the application internally rather than having it hosted and operated remotely by a vendor (though Halogen can handle hosting/operations for customers who choose that approach). A select group of Main Line Health team members took part in software demonstrations and site visits. The multi-disciplinary team included members of various health system business units, HR directors and the director of compensation.

Main Line Health selected Halogen Software because of its ability to include the health system's existing assessment forms electronically. Those forms are now online, and will be revised and enhanced over the coming years. The software company is also a vendor of choice for the American Hospital Association.

Halogen includes compliance forms, a medical library, a legal dictionary and a comment/help section -- which has assisted the health system's managers immensely, McAnally said. The intuitive software allows for easy automation of the health system's forms. "The health system decided to use the existing forms and automate them, because the staff was familiar with them. It's also a way of easing the staff into using the online forms," she said

Donna Ronayne, vice president of marketing and business development at Halogen Software, said that a lot of organizations first automate their existing appraisal process and paper forms. "For many organizations, their employee appraisal processes are labor-intensive and they often don't have an opportunity to focus on improving the processes or tweak the forms in anyway," Ronayne said during a recent interview. "They just try to survive by getting the appraisals done, because they're so burdened with the administrative work. And a hospital can literally have a different form for every fourth employee on staff, so if you have 10,000 employees, you can have more than 2,500 different forms. That's an incredible amount of forms to be managed."

The system can be used by peers, customers and staff to assess an employees' job performance, Jean Kozicki, director of recruitment at Main Line Health, said. "Halogen's multi-rater system allows a manager to electronically request performance feedback, compile the results and display individualized comments," said Kozicki, during a recent interview. "Employees are active participants throughout the entire assessment process, including being able to review their appraisals throughout the year to make sure they're working toward previously established goals and objectives. Employees can record things in a performance journal [e.g., items that they want to discuss during their annual review]. And all the information is secure and stored electronically."

Once an employee's performance review is complete, the system converts the review file to a PDF. The employee cannot make further changes to his/her review document. However, he/she can view the document throughout the year to assess his/her progress in achieving work objectives and goals, McAnally said. The PDF is electronically signed by the employee and date-stamped by the software.

Health care magnified

"Hospital human resource departments operate like they are on steroids because everything they do seems to be magnified 10 times or more," Ronayne said.

The appraisals done in health care are much more intensive and must follow regulations more closely than in other industries. "Health care has a lot of different forms, clinical competencies and checklists, as well as orientation checklists, which are different than what has to be done in normal appraisals, because of the clinical competencies. In addition, behavioral competencies have to be assessed," Ronayne explained.

Ronayne said the biggest challenge for an organization that's bulldozing mountains of paper is knowing where things stand at any given point during the appraisal process. "Appraisals would be sent out in Word documents and spreadsheets, and nobody would know where they were in the appraisal process," she said of the old process. "The person in HR overseeing the review process hopes the line managers get them done, and if not, then the HR person becomes a nagger."

With Halogen Software e-Appraisal, the correct forms are sent to the manager automatically. "The managers receive all of the appropriate background information [e.g., certificates or licensing items that need renewal], or anything that has to be included in a review [e.g., past appraisals, multi-rater reports, journal notes from the system, etc.]," she said. The system gives the manager tools to help them write a more meaningful appraisal. "The system suggests appropriate feedback and helps with the language, so that in the end the system not only cuts the manager's time substantially, but also provides all essential background materials."

The Sarbanes-Oxley legislation is forcing many publicly traded organizations to make performance reviews more visible within the organization and to its staff in order to justify fairness in pay adjustments, stock options and bonuses. This practice, however, has also proven beneficial for attracting and retaining employees in general. "This system makes everybody accountable," Ronayne said. "In the past, nobody knew what was taking place at any given time during an appraisal. Now with this system, a management dashboard shows where everyone is in the process, who is late, or who has yet to begin the process. It also shows who is working on corporate goals and how they are doing, who the top performers are in various areas and other important trends."

No longer does the HR staff at Main Line Health have to move mountains of paper to perform an employee's appraisal -- or understand the performance of their workforce. Everything is available at their fingertips.

Mr. Mitchell is managing editor of ADVANCE for Health Information Executives.