Mrs. X is an RN who has been employed in your hospital for ten years. She is a middle aged woman supporting a large family and it is common knowledge that she moonlights at a nursing home on her days off. Her work is generally of high quality; but in reviewing her past performance appraisals you notice that in the last four years at each evaluation she has been rated unsatisfactory for being on duty promptly; as well as for not attending staff development programs. Since you are the new unit manager, you would like to be able to improve Ms. Lee’s performance in these two areas. Discuss this with your partner, Mrs. X

Dr. S.J. NALINI Reader Faculty of Nursing, Sri Ramachandra University

PERFORMANCE – 2 Elements  MOTIVATION  ABILITY

the ability to get individuals to do what you want them to do, when and how you want it done MOTIVATION

FIND THE RIGHT REWARDS IN ORDER TO MOTIVATE OTHERS! Personal Economic Creative

MOTIVATION  Understanding how others work.  Some internal or external force to move human beings to continuous high levels of productivity.  Have an effect on outcomes such as performance, turnover, and absenteeism

COMPREHENSIVE APPRAISAL SYSTEM Determine ability required Match ability of job and employee Improve employee’s abilities (staff development) Enhance employee’s motivation (reward system)

A simplified model of job performance MOTIVATION Benefits Job design Leadership style Recruitment and selection Employee goals/needs/ abilities ABILITY Responsibilities Education – Basic/ advanced CNE Skills/abilities EMPLOYEE PERFORMANCE Daily performance Attendance Punctuality Adherence to Policies/procedures Absence of incidents/ errors/accidents Honesty Trustworthiness

PERFORMANCE APPRAISAL Systematic, standardized evaluation of an employee by the supervisor, aimed at judging the value of the employee’s work contribution, quality of work, and potential for advancement

PERFORMANCE APPRAISAL Definition The process of interaction, written documentation, formal interview and follow up that occurs between managers and their employees in order to give feedback, make decisions and cover fair employment practice law - Eleanor J Sullivan

PERFORMANCE APPRAISAL Definition Is a periodic formal evaluation of how well the nurse has performed her duties during a specified period - Ann Mariner

GOAL OF PERFORMANCE APPRAISAL?  To improve performance  Letting employee “know where they stand”  Giving performance feedback - strongest nonfinancial reward!

Purposes  Determine job competence  Enhance staff development  Discover employee’s aspirations  Recognize accomplishments  Improve communications  Aid in manager’s coaching and counseling  Determine training and developmental needs  Make inventories of talents  Select for advancement of salary  Identify unsatisfactory employees

Is your appraisal system nondiscriminatory? Be in writing and carried out at least once in a year Share with employee Opportunity to respond in writing Appeal the results Opportunity for observation Maintenance of Anecdotal reports/critical incidents Training of evaluators Focus on employee behavior and results rather on personal traits or characteristics

Evaluation Philosophy  ABSOLUTE JUDGEMENT: Based on reasonable and acceptable standards set by the organization  COMPARATIVE JUDGEMENT: Employees are compared with each other

Errors in evaluation ▲ Halo error ▲ Horns error ▲ Contrast error ▲ Leniency error ▲ Recency error

Guidelines for Performance Criteria Realistic Measurable and verifiable Practical Relevant Non Discriminating Stable Time bound Written

PERFORMANCE APPRAISAL PROCESS Step 1 Assess institutional and personal needs and set goals Step 2 Establish objectives and time frame Step 3 Assess progress Step 4 Evaluate progress

Performance Appraisal Mechanisms Personal Peer Managerial evaluation –Evaluative Making decisions/rewards (past performance) –Judgmental or developmental Role as counselor, areas of improvement Identifying resources available

FORMAL AND INFORMAL PROCESS Informal - day-to-day –Coaching - approach to developing people –Ongoing, face-to-face collaboration Formal –Written documentation –Formal appraisal interview with follow-up Work is measured against some standard for the purposes of determining the level of quality of job performance

PERFORMANCE MEASUREMENT TOOLS  Anecdotal Notes  Checklists  Rating Scale  Numerical  Graphic  Descriptive  Frequency rating scale

PERFORMANCE MEASUREMENT TOOLS  Behaviorally Anchored Rating Scales (BARS)/  Behavioral expectation scales (BES)  Behavioral Observation scales (BOS)  Ranking - Paired comparison : N(N-1)/2  Management by objectives

Management by Objectives  Review the mission and group objectives  List major job responsibilities  Determine expected levels of accomplishment  Meet manager to establish priorities  Develop plans for the accomplishment of the objectives  Annual review – comparison of actual results with expected levels of accomplishment

Advantages of MBO - staff  Works on participative management  Based on characteristics of a specific person and job  Control and emphasis over future  Awareness of the standards of judgment, goals, priorities and deadlines  Understanding about progress  Stimulates higher individual performance / morale

Advantages of MBO - manager Reservoir of personnel data and performance information Basis for promotion/ compensation Relationship with staff as coach Directs work activities towards organization goals Facilitates planning Objective appraisal criteria Reduces role conflict

Limitations of MBO  Difficult of implement  Needs teaching and reinforcement  Manager responsible for assessing results and not activities directed towards results  Some nurses do not want to be involved in setting goals  Only lip service  Stresses on results but not on methods to achieve them  Frustration when higher goals are set  Neglects qualitative factors  No comparative data for promotion/ salary increase

Key concept: Clients, peers and superiors are always evaluating a nurse’s performance!

Who is a peer? A peer is a person of the same profession, grade or setting.

Peer review A process whereby a group of practicing registered nurses evaluate the quality of another RN’s professional performance Ann Mariner A process by which other employees assess and judge the performance of professional peers against predetermined standards - Eleanor J Sullivan

An organised effort where people critically appraise, systematically assess, monitor, make judgements, determine their strengths and weakness and review the quality of their practice, to provide evidence to use as the basis of recommendations by obtaining the opinion of their peers. Offers staff an opportunity to both give and receive support, and to network across the site involved.

Peer evaluation process Review of employee’s self evaluation form Reference letters, committee work, special projects, additional education, contributions to nursing Performance evaluation by manager Review of past performance, care plans and charting Assessments, observation of the nurse Interviews with her patients Summary of findings Presentation of findings and recommendations to the nurse

Advantages & Limitations Advantages:  Accountability and responsibility for nursing performance. Limitations:  Threatening and time consuming  Risk of rating candidates too high or too low

Appraisal interview Tell and sell Tell and listen Problem solving Goal setting

Appraisal interview style Purposes of evaluation Manager’s philosophy of management Institutional guidelines

Key behaviors for an appraisal interview Put the employee at ease Atmosphere creation Clearly state the purpose of the interview Go through the ratings one by one with the employee Draw out the employee’s reactions to the ratings Decide on specific ways in which performance areas can be strengthened Set a follow up date Express confidence in the employee.

PERFORMANCE APPRAISAL OUTCOMES improve performance improve communication reinforce positive behavior method to communicate/correct provide basis for regards/basis for motivation provide basis for termination if necessary identify learning needs and develop personnel