PERFORMANCE CORRECTION NOTICE

DISCIPLINARY LEVEL

Verbal Correction—(To memorialize the conversation.)

Written Warning—(State nature of offense, method of correction, and action to be taken if offense is repeated.)

Investigatory Leave—(Include length of time and nature of review.)

Final Written Warning

Without decision-making leave

With decision-making leave (Attach memo of instructions.)

With unpaid suspension

SUBJECT:Substandard work performance

Policy/Procedure Violation

Performance Transgression

Behavior/Conduct Infraction

Absenteeism/Tardiness

PRIOR NOTIFICATIONS

Incident Description and Supporting Details: Include the following information: Time, Place, Date of Occurrence, and Persons Present as well as Organizational Impact.

Paul,

To date you have had a number of serious performance issues in the warehouse. Now today, on May 1, 2017, you have again failed to perform one of your essential job functions—the timely delivery of supplies. Specifically, you delivered an incomplete order of medical supplies to Nursing Wing A and also failed to provide the proper paperwork to the charge nurse. As a result, there was a delay in the delivery of supplies, and patient care and the work flow were disrupted. This violates our hospital’s standards of performance and conduct and also shows a further breach of your responsibilities as outlined in your previous warnings.

PERFORMANCE IMPROVEMENT PLAN

1. Measurable/Tangible Improvement Goals: Paul, I expect that no further incidents of misplaced or misdelivered packages or orders will occur in the next ninety days. In addition, I require that you communicate both openly and on a timely basis with us concerning the status of your work and anything that prevents you from completing your assignments in a timely manner.

2. Training or Special Direction Provided: Dave Wilson and I will commit to spending more time with you providing clear and concise direction and feedback. For the next five days, Dave will meet with you daily before you begin rounds to discuss your delivery agenda.

3. Interim Performance Evaluation Necessary? No

4. Our Employee Assistance Program (EAP) provider, Prime Behavioral Health Group, can be confidentially reached to assist you at (800) 555-5555. This is strictly voluntary. A booklet regarding the EAP’s services is available from Human Resources.

5. In addition, I recognize that you may have certain ideas to improve your performance. Therefore, I encourage you to provide your own Personal Improvement Plan Input and Suggestions:

(Attach additional sheets if needed.)

OUTCOMES AND CONSEQUENCES

Positive: I will remain available to help you and discuss areas where you require additional support. If you meet your performance goals, no further disciplinary action will be taken regarding this issue. In addition, you will develop a greater sense of accomplishment in helping our hospital to meet its production goals and in providing direct support to our patient care areas.

Negative: You are now being placed on final written warning. If at any time in the next ninety days you fail to meet the guidelines established in this disciplinary write-up in terms of the timely delivery of supplies or completed paperwork, or if you violate any other organizational standards of performance and conduct, you may be discharged. A copy of this document will be placed in your personnel file.

Scheduled Review Date: Ninety days (August 1, 2017)

EMPLOYEE COMMENTS AND/OR REBUTTAL

EMPLOYEE ACKNOWLEDGMENT GOES HERE

Note: Because this is a final written warning, add this sentence to the end of the Employee Acknowledgment: “In addition, I understand that this is my last chance and that I am in serious jeopardy of losing my job. If I breach any of the performance standards established in this notice, I will voluntarily resign or be discharged for cause.”