When a team member runs afoul of your hospital policies, you might be tempted to fire him or her on the spot. Or, at the other extreme, you may shrug off the incident, thinking, "Surely this won't happen again." Both of these reactions are the wrong move.

The best approach? Progressive discipline. Here's how it works: The first time a team member breaks a rule, warn her not to do it again. The second time there's an episode, create a written reprimand. The third infraction means probation. After the fourth offense, it's time to send her packing. For the process to be fair and reasonable, the team member needs to know what the problem is, what needs to be done to fix it, how long he or she has to make the change, and the consequences of inaction. Communication among all involved parties is key.

Take some advice from your counterparts in chiropractic care. Dr. Dan Spencer, a chiropractor with offices in Hudson and Reading, Mich., has a section in his practice's employee manual that's prefaced by this statement: "The officers of the corporation reserve the right to determine if policy was violated, the significance of the violation, and what action is appropriate." The manual then spells out four levels of disciplinary action: a verbal warning, a one-day suspension without pay, a one-week suspension without pay, and termination.

One final tip: In the interest of fairness, ask yourself, "How would I respond if my best-performing employee committed the same error?" If you would respond the same way with your top team member as you would with an employee who's having difficulty meeting job expectations, then you know you're acting reasonably.

Veterinary Economics Editorial Advisory Board member Bob Levoy is the author of 222 Secrets of Hiring, Managing, and Retaining Great Employees in Healthcare Practices (Jones and Bartlett, 2007).