The 360 Evaluation

By  |  December 29, 2008 | 

Rob Bessler writes…

The New Year is upon us. Hospital medicine’s busiest time of year. There is no better time than now to do some needed housekeeping for your practice site. It is our belief at Sound that there is nothing more important that the quality of the team that we develop and support.  The team and all the clichés that go with that power are real. No individual is as strong in isolation as when powered by the collective support of the team.  These teams can then become the lifeblood of the hospital and the community they serve. Where strong teams exist, turn over is extraordinarily low and when it does occur the team keeps ugrading the talent. This cycle feeds on itself.

How many hospitalists out there have paused recently to talk in small groups with their peers about how their practice is shaping up and how you are all interacting together? I wanted to share with you all a simple concept, not unique to us or hospital medicine, that can transform a team.

The 360 evaluation.  How many times have you wanted to tell that one doc in the group that their individual views are not shared by all team members? That they don’t speak for the group, that their sign out is not as good as everyone else’s. When we follow you after night shift there are many uncovered rocks to deal with.

The 360 is a way to give and receive feedback. It doesn’t need to be scientific or complicated. Work with a few docs on your team to come up with the questions you want everyone to answer about everyone else. Don’t forget to put in some opportunities for people to be complimented for their positive attributes. The positive reinforcement will propel these attributes to an even higher level. The examples are better in our view than the multiple choice responses. The opportunity to get real feedback from your peers helps develop the team. We have found peer pressure to fit in with the team expectations the greatest motivator.  If you can access the resources of a professional coach or trainer to help facilitate and give needed feedback to both the process and skills sets needed for individuals, then you really are driving things forward..  A strong team is the lifeblood we are after and I encourage you to give it a try.  Starting out the New Year with this fresh approach to drive performance and satisfaction of the team forward is a great way to start 2009. Happy New Year.


  1. Rob Zipper January 10, 2009 at 3:25 pm - Reply

    As one of Sound’s Chief Hospitalists, I have found the 360 evaluation to be a very valuable tool. It helped create a positive and open atmosphere for delivering peer feedback, which is otherwise very difficult to do in the flow of any hospitalist’s busy day. It also allowed me an opportunity to learn about each of our clinicians’ aspirations, whether they be medical or in the realm of leadership. I can enthusiastically say that it has strengthened the cohesiveness of our team.

  2. Tommy Lee January 21, 2009 at 11:01 pm - Reply

    Hi there, Good information on your site for cycle trainers and your post regarding The 360 Evaluation looks very interesting. Keep up the good work.

  3. Wiley Robinson,MD March 31, 2009 at 9:06 pm - Reply

    Great column.
    We are having dificulty with our hospital’s length of stay data.
    The include all patients(even those who stay for a month in the ICU) and they make no attempt to assign any of the LOS to consultants who are co-managing the patient.
    What is the national standard for collecting and calculating or measuring this information?

  4. Robert Bessler M.D. April 4, 2009 at 4:14 am - Reply

    Thanks for your comments. I suggest you use the generally accepted approach related to the medicare outlier payment system. Most hospital cfo’s are comfortable with this approach. Under this approach you would remove patients that fall into the outlier status since the hospital’s payment is different as well. We also have an ability to track it through our web based information system our hospitalists and programmers have developed over the last 5 years. Let me know if you have any questions.

    All the best,

  5. Christopher Dowd, DO April 22, 2009 at 10:56 pm - Reply

    A follow up on the LOS and physician to whom it is assigned. I’ve recently worked with our VPMA and orthopedic surgery colleagues to develop an agreement regarding patients needing admission for an orthopedic issue, but whom also have medical co-morbidities. Briefly, as part of the agreement, we agree to take orthopedic patients who develop prolonged hospital stays due to medical complications onto our service as a transfer. My understanding has always been that LOS was attributed to the admitting physician, but I just spoke with one of the data people for our system, and she said they have been using the discharging physician. This will obviously have a negative impact on our LOS since these patients have, by definition, a prolonged LOS. Do you, or does anyone, know if there a standard for which physician LOS is attibuted to?

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