There's no getting around it: At some point you're going to have to manage a difficult employee, someone who negatively impacts the image or services of your facility. How you deal with the inevitable staffing challenge can turn a messy situation into a (mostly) positive outcome. Handle difficult workers by first identifying the cause of their problem behavior.

• Is it because of experience and qualifications? Employees that can't complete assigned tasks are a detriment to your entire staff. They slow case efficiencies, create frustrations among co-workers and can ultimately jeopardize patient safety. The good news: These problem employees often identify themselves. When you're aware of someone who needs to improve her daily performance, and you believe her problems are linked to a lack of experience or qualifications, set the progressive discipline wheels in motion. That entails a verbal first warning, a written second warning and a third warning that could result in termination of employment. Document all warnings and don't let issues persist over an extended period.
• Is it because of working style? Employees can create problems simply because their temperaments aren't compatible with their workplace responsibilities (see "Which Personality Type Are You and Your Staff?"). Ideally, you should identify a key candidate's personality temperament to see if it'll mesh with the job for which she's applying before making an offer. Many surgical facilities are starting to do just that in order to make the right hire more often.

While personality temperaments tend to remain constant, you might be able to find a job that's a better fit for a current employee if you believe her personality temperament is preventing her from excelling in her current role and her qualifications allow for a shift in responsibilities. You'd be surprised how often a simple position change can make a big difference in an employee's performance. A light goes on in her head, she feels comfortable in her new role and you've gained a valuable worker instead of phasing out someone whom you might have pegged as a lost cause.

• Is it because of character? The popular book Good to Great by Jim Collins says a person's character is more important than any other trait. That may be true, since character is directly related to trust, loyalty, dependability and honesty. If you can identify a person's character, you'll most likely be able to accurately predict how she'll react in most workplace scenarios. However, character is a lot harder to judge than other personality traits.

Check with a potential hire's references to get a sense of how she acted and behaved during good times and challenging situations. Also observe your current employees' actions over time, keeping football great Johnny Unitas's advice in mind: The true judge of a person's character is how he treats those who can't help him get ahead in life. Above all else, trust your own instincts because your gut reaction is usually right.

There are exceptions, of course, but a truthful person will always tell the truth and a liar will always lie. If you discover that character flaws are the cause of an employee's workplace problems, those issues probably won't change. Unfortunately, it's best to suggest that those with character flaws find work elsewhere.

A vocal minority
It's been said that 10% of employees cause 90% of workplace problems. Don't let a few poor performing staffers disrupt your day to day. Do your best to fill openings with highly qualified, high-character people who have the right personalities for their jobs. When issues arise with your current staff, assess the cause of the problem and use those insights to reach a resolution that's best for the difficult employee and, above all, your facility, staff and patients.