Currently, there is a climate of concern in many companies for evaluation of program effectiveness and assessment of return on investment (ROI). Moreover, some forward-thinking organizations are even beginning to realize that the "health" of employee performance on the job must be attended to with the same concern as the physical well-being of workers. This realization has led to the growth of a movement known as "performance care," which in many respects parallels more familiar health-care initiatives.

At the center of a movement toward increased focus on "performance care" is the issue of performance diagnosis, or the methods by which an organization can know about the state of health of it’s collective performance. Just as with health care, effective performance diagnosis is essential to timely prescription and treatment. An important question here, however, concerns the possible relation between performance diagnosis implementation and bottom-line changes for the organization.

Consider the case of an organization wanting to assess the "health" of its field sales operations. To accomplish this goal, the organization should conduct routine check-ups using appropriate performance diagnostic tools. The results of these tests will tell the organization where its sales operation stands, and what needs to be done to improve effectiveness, if anything.

Inevitably, the question arises as to justification for the cost of performance diagnosis. Is it something that itself can be expected to produce ROI? Can performance diagnosis really cause an increase in sales? Under what conditions would such a relation be expected to occur? Answers to these questions seem fundamental to a full understanding of the performance-care process, as well as to the kinds of promises that can be made about outcomes which may result from it. But, to develop these answers, we must briefly consider the matter of causality.

ABOUT CAUSALITY

One of the most useful discussions of this matter I have encountered recently was provided by Fred Dretske, a professor of philosophy from Stanford University. Dretske offered a distinction that seems quite relevant to our present concern about the causal efficacy of performance diagnosis. I will attempt to paraphrase his treatment. When one considers the cause(s) of some happening in the world, let's call it Event X, there are at least two kinds of potentially relevant factors: Those that enabled it and those that triggered, or precipitated it. The Enabling factors set the stage or lay the groundwork for Event X, but do not produce it in and of themselves. In contrast, the precipitating factors actually trigger the occurrence of Event X.

Perhaps an analogy is helpful at this point. Consider the X-ray and its relation to the healing (Event X) of a broken bone. In this case, is the X-ray enabling or precipitating of Event X? A moment's thought indicates that the X-ray merely provided the conditions under which knowledgeable people (technicians and doctors) could prescribe and implement a proper treatment (a cast) for the broken bone. Although both factors (X-ray and cast) obviously contributed to healing, the cast should properly be viewed as precipitating (i.e., causing) the healing. The relationship between X-ray and healing is much too indirect to be considered causal in the usual sense. Indeed, in the hands of unskilled people, the X-ray might have been quite useless. Thus, the X-ray can accept neither credit nor blame for the final outcome. Only the actions taken, in light of information provided by the X-ray, were responsible for the result.

PERFORMANCE DIAGNOSIS AS AN ENABLING EVENT

With similar logic, I wish to argue that it is neither fair nor appropriate to suggest that performance diagnosis itself causes (or fails to cause) an increase in sales. Clearly, like an X-ray, performance diagnosis is only a device that provides information to knowledgeable people who are then enabled to prescribe proper treatments. In the case of performance effectiveness (i.e., health), for example, these treatments would be some type of maintenance or improvement strategies for field sales operation. Yet, it is only when such strategies are (1) properly formulated, (2) successfully implemented, and (3) actually effective that bottom line results may be expected to occur. Although these three precipitating steps to success may be enabled by performance diagnosis, they are by no means guaranteed by it. Consequently, the diagnostic process itself cannot accept either glory or shame, insofar as success of the final treatment is concerned.

EVALUATING PERFORMANCE DIAGNOSTIC EFFECTIVENESS

Does this mean that performance diagnosis bears no burden of accountability? On the contrary. But, its accountability does not lie in the eventual success of treatments prescribed on the basis of information it supplies. Rather, a performance diagnostic process is accountable for the value (i.e., accuracy, specificity, and completeness) of the information it yields about employee performance. In other words, it is accountable only for its ability to support informed decision-making and treatment. So, to evaluate the success of the performance diagnosis, one must ask: Does it enable formulation of performance improvement strategies more effectively, efficiently or with less cost than other alternative diagnostic approaches?

Similar questions have been asked about X-rays. The diagnostic limitations of this conventional technology are well known. In part, these limitations have lead to more sophisticated alternatives, such as CT scans and MRIs, each with their own cost/benefit profiles. When one thinks of justifying one or another of these health-care diagnostic alternatives to a patient, the effectiveness of eventual treatment regimens is never the central issue. Instead, concerns focus on the clarity and extent of information provided by the diagnostic tool about the underlying problem(s). A patient with frequent headaches and blurred vision does not elect to spend hundreds or thousands of dollars on an MRI because doing so will cure the problem. The money is spent in order to provide sufficient data to determine the nature of any underlying disorder. Is there an organic problem such as a brain tumor? There is little question that having more detailed diagnostic information can enable more informed recommendations about alternative treatment options for the patient.

It seems to me that the role of diagnosis in a performance-care initiative is subject to essentially the same considerations. The justification for conducting performance diagnosis is not that it will increase sales or have a direct impact on the bottom line. Rather, a diagnostic activity should be conducted precisely in order to determine if controllable circumstances exist which, if properly treated, could result in increased sales. The value of performance diagnosis lies exclusively in the quality of the information it provides about the state of sales-relevant performance in the field sales operation, or any other aspect of the organization for that matter. Subsequent formulation of relevant and successful performance treatments, not to mention patient compliance, are beyond the scope of the diagnostic process itself.