Overview: In this case study, you will analyze the employee job performance and appraisal process.

Case Study: Margie has been a coder in the HIM department of a large acute-care facility for the past 10 years and, prior to working at this organization, she coded for 15 years at a similarly sized acute-care facility. Throughout her coding tenure, Margie mostly coded outpatient encounters such as outpatient observations, outpatient surgeries, and emergency room visits. Two years ago, Margie was cross-trained to code inpatient discharges as well. At last year’s performance appraisal, Margie received an overall score of 3.8 out of 5, which denotes that she “exceeds job performance expectations.” This past performance appraisal cycle, the HIM coding area and Margie personally experienced the following changes:

· The hospital implemented a new EHR that required extensive training for all hospital employees.

· The coding area had some management turnover with the long-term coding manager retiring and the coding lead promoted to the coding manager position.

 · The HIM department’s coding productivity was updated to include computer-assisted coding and all coders went from using one monitor to dual monitors. Computer-assisted coding also means that Margie transitioned from coding with hard copies of coding books and references to reviewing and validating codes within the EHR, based on the clinical documentation provided by the practitioners.

 · Margie used to sit in a quiet office area with one other individual, but the department was reconfigured and all coders were moved to a central location. The coding office is a large room with each coder occupying a cubby-type area with dividers between each desk. The noise in the open concept office tends to magnify, even with the dividers.

 · Margie’s husband had some health issues as well, which caused Margie to be on family medical leave for six weeks.

It is the time of year for conducting all performance appraisal reviews and Margie has expectations that her performance evaluation will be similar to last year’s. Margie’s coding manager set up a time to go over Margie’s review—Friday at 3:00 p.m. in the manager’s office. Margie arrives promptly at the manager’s office, but has to sit outside the office for 10 minutes waiting for the coding manager to finish up a personal phone call. When Margie enters the room, the coding manager has music playing from her iPhone and her computer is open with the email notification on. Margie sits down at the chair on the other side of the manager’s desk; the coding manager hands Margie the evaluation and says, “Review this and let me know if you have any questions, please; I have to answer a few emails because it is Friday afternoon.”

Margie reviews the evaluation and is stunned by the final evaluation score that she is receiving this year. Her final score is a 2.8 out of 5 and she is being put on a performance improvement plan (PIP) with no pay raise. There are items included in the evaluation that Margie had no idea had been a problem throughout the year. Margie’s productivity and quality were marked below average and the statistics included in the review were ones that Margie had not seen all year. As Margie reads the evaluation, the coding manager’s phone keeps ringing and the manager keeps answering her emails. Margie is very upset and tries to address the evaluation with the coding manager, which in turn makes the coding manager defensive. The coding manager is not open to discussing any of incidences noted in the evaluation and she states that she does not have time to review Margie’s monthly productivity and quality scores with her. As Margie typically does not like conflict, she signs the evaluation and PIP, but is very upset leaving the room. The coding manager does not seem to notice that Margie is upset and continues answering her emails.

Two months later, Margie accepts another job at a specialty hospital within the same geographic region of her facility and she resigns with a two-week notification.


· All performance appraisal reviews for the organization are performed at the end of the fiscal year.

 · The healthcare facility requires periodic reviews of performance throughout the performance cycle, but Margie did not receive any periodic feedback throughout the performance cycle.

 · Margie did not get a chance to perform a self-evaluation or request 360-degree performance review from her peers.

This case study was obtained from Management for the Health Information Professional (pp. 196–197).

Prompt: Respond to the case study by considering the following:

· Considering employee job appraisal processes, what process was used?

 · What items specifically affected an employee’s work performance? Why

 · Describe the appraisal process and discuss recommendations for improvement.

 · Evaluate the actual appraisal process and discuss recommendations for improvement.

 · What managerial skills and actions should have been applied to the appraisal process and why?

 · How can a culture of belonging and agency be presented?

This assignment will help you understand risk assessment and quality improvement in healthcare, which you can incorporate into your final project.

Guidelines for Submission: Your paper should be submitted a 2-page Microsoft Word document in APA format with double spacing, 12-point Times New Roman font, one-inch margins.

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