Amy Stewart

How can I determine if a problem rises to the level of requiring a performance improvement plan (PIP)?

A PIP is a concentrated effort on a particular problem in one area that requires systematically gathering information to clarify issues and intervening for improvement. It requires a team of people who come together for a period of time to develop changes in a system or process. If a facility’s concern can most effectively be solved by convening cross-functional experts to systematize issue exploration and remediation, the facility should consider a PIP. 

However, not every issue requires a PIP. If education, new information or a simple change in a process will fix the concern, then a PIP probably isn’t necessary. For example, if it was determined that residents’ weight loss was due to an issue with the scale battery, and after a battery replacement the suspected weight loss was determined to be the result of a faulty scale, then a PIP isn’t needed. 

In contrast, if the problem can best be solved by bringing a team of people together, using additional resources to determine the root cause, and trying interventions to prevent recurrence, then it likely rises to the level of requiring a PIP. For example, weight loss might be trending upward as a result of a dining service process issue. To get to the root cause, facility leaders need input from nursing, CNAs and dietary staff. Developing and implementing trials of a new process would likewise require a team effort, and a PIP is likely needed. 

It is important to remember that an increase in a certain problem is an indicator, which may mean there is an actual problem requiring a PIP. If the analysis reveals that a team of experts developing and testing changes is needed, then the facility requires a PIP.