March 9, 2007

elevate: Answering the Tough Questions

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Medical Center leadership answers the tough questions about what the elevate program is and what it means for the people who work at VUMC.

Question: How does VUMC raise the organizational bar yet keep 60 percent of folks at a “3” on performance evaluations?

Answer: This question refers to our guidelines for scoring staff job performance: about 60 percent of staff should earn a score of 3; 25 percent should earn a 4; and 10 percent should earn the top score of 5.

The distribution of performance scores helps make the pay-for-performance system meaningful, allowing us to award substantially larger annual salary adjustments to high scorers, thus helping VUMC retain its best performers. We are convinced that our pay-for-performance program is good for recruitment, retention and ongoing performance.

Under elevate, we've kept our basic strategy of carefully gauging expected and exceptional levels of job performance and adjusting staff compensation accordingly. As we move from good to great, our expectations — and even the definition of what expected performance is — are changing.

Through the elevate process, we're raising both our overall performance expectations and our ability to perform at those higher levels. When what was once considered high performance has become the expectation, we think there will still be those who outperform expectations. Though our expectations and performance levels are rising, the overall distribution curve of our job performance scores needn't change.

We would also like to take this opportunity to remind everyone that elevate is helping to make VUMC more successful, and when we succeed in growing the bottom line we are committed to use a portion of those additional funds to increase the compensation of all VUMC employees.

— Harry Jacobson, M.D., vice chancellor for Health Affairs