Employee Engagement Feedback Using the Sandwich Technique

Combining compliments with constructive criticism is a lot easier for an employee to digest

On occasion, we are all called upon to criticize or correct a staff member or employee. For the most part, this is uncomfortable for the doctor or manager as well as the employee. Usually, the employee engagement discussion tells the individual about some action or behavior that is unacceptable or needs correcting.

In this situation, the employee often goes on defense. This can become a very contentious situation and little or nothing is accomplished. Some doctors and office managers have described the feedback process as a “manure sandwich” – to use a nicer term than a cruder, more popular version of this sandwich!

I would like to share an approach that I have used that reduces the tension and anxiety for both the manager and the employee. This blog will discuss the sandwich technique of employee engagement to provide constructive criticism to employees.

The basic formula for the sandwich is:

• Start with a positive comment to the employee – the slice of bread on top.
• Let the employee tell her/his story – lettuce, tomato, cheese.
• Explain the problem and then tell what is expected of the employee – the meat (manure in this instance as it is the bad news).
• End with a positive comment or compliment – the slice of bread on the bottom.

For example, the practice’s policy may prohibit personal cell phone use during office hours. But an employee is repeatedly found using the phone, despite warnings from the office manager that this behavior is not acceptable. The office manager might ask the doctor to get involved in correcting the situation.

An employee engagement sandwich scenario

This is how the sandwich technique might be used to deal with an errant employee.

Doctor: Welcome Ms. Breakwater. I hear so many nice compliments about you from our patients. I heard how you went the extra mile to help a patient obtain a prior authorization in December so that the patient didn’t have to pay the deductible if the test would be done after the new year. Also, the staff really enjoys working with you, and the office manager reports that you are doing a nice job as a medical assistant. Tell me, what is your experience with our practice and how do you find the workload? 

[Employee now has an opportunity to discuss her work experience and her interaction with the patients and the staff.]

Doctor: Are you aware of the office policy about using the cellphone and texting during office hours? Is there any reason that you need to be texting during office hours?

Employee: Yes, I am knowledgeable about the policy. I suppose I don’t have to be on my phone during office hours.

Doctor: It is my understanding that you have been told that using your phone during office hours is not allowed. Is that correct?

Employee: Yes, I was told by the office manager on a few occasions.

Doctor: Are you aware that your phone use is setting a poor example to other employees, and that other employees might feel they can use their cell phones if you are doing it and getting away with it? What I’m really asking you Ms. Breakwater is, can you see how this might be impacting morale in the office and that it will ultimately detract from patient care?

Employee: Yes, I understand where you are coming from and your concerns.

Doctor: What can I do to help you avoid the use of your cellphone during office hours? Would you consider turning off your phone and putting it in your purse when you come in during the morning?

Employee: Yes, I would be willing to try that.

Doctor: Is there anything else you would like to discuss today?

Employee: No.

Doctor: Could we set up a meeting in 30 days and discuss your progress? Let’s sign an agreement between us that you will not use the cellphone during office hours unless absolutely necessary.

[This documentation may be helpful in the future if the employee fails to follow office policy.]

Employee: Sure, I can do that.

Doctor: In summary, I believe you are an asset to the practice. We all enjoy having you here. I think you are a valuable member of the team and I want you to know how appreciated you are in this practice.

Why consider the sandwich technique of constructive criticism? 

The sandwich technique of employee engagement is an effective method that doctors and office managers can utilize in the practice for a gentler approach when giving constructive criticism. It can also be used to give bad news to an employee.

There are two advantages of the sandwich technique of employee engagement in a medical practice.

1. Beginning with a compliment eases into the possibly tense discussion before explaining where there is room for improvement.
2. Ending with praise can smooth the employee’s feelings of having been criticized by making her feel appreciated nonetheless.

Bottom line: I think you will have success in communicating the need for behavior change if you utilize the sandwich method. Always begin with a positive observation of affirmative behavior or a character trait. This is followed by constructive criticism in a positive tone and friendly demeanor. Then end the conversation on another positive note with a slice of bread or a compliment on the top.