Surviving the performance appraisal.
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In a climate of financial viability in early 1986, productivity measurement and analysis were implemented as major components of the quality assurance program at University Medical Center at the Arizona Health Sciences Center. The purpose was basically to balance the benefits of conducting an integrated quality assurance program with the operational costs. A fully integrated quality assurance program was implemented at University Medical Center during June, 1985. Comprehensive, 100 percent chart screening is conducted utilizing occurrence screening criteria and criteria for all required JCAH clinical monitors. The quality assurance program is based on the Medical Management Analysis (MMA) system established by Joyce W. Craddick, M.D. Since the immediate plan of the hospital administration's financial sector was to develop units of service for nonrevenue-producing cost centers, the QA director was obligated to develop standards that would demonstrate effective management of the QA department's resources and would project revenue requirements for program development. The QA director elected to conduct a productivity study which resulted in the establishment of performance standards that are currently utilized in budget development to determine staffing needs; to appraise employee performance; and to perform trend analysis.
For their own reasons, both healthcare managers and employees dislike performance evaluation interviews. Managers would rather avoid the role of appraiser, and employees often dispute the accuracy of their assessments. The resulting poorly handled interview often resembles a power struggle more than a performance review. This article describes several interview formats that might be appropriate to certain situations and advocates training for managers who must conduct performance evaluation interviews.
The idea of evaluation, or the measurement of a person, a service or a programme against some type of yardstick, has been around for a long time. In everyday language, the term evaluation is used to refer to everything from employee performance appraisal, to informal opinions about whether a particular service appears to be working well, to carefully planned and executed programmes of evaluation. In the past, librarians have tended to rely on their own professional judgement as a primary means of informal evaluation, and as long as the librarian was considered competent by others in the organization, this method seemed to work reasonably well. In the rapidly changing fiscal climate of the 1990s, greater demands for accountability are altering the standards of evaluation, and informal methods based on professional judgement are less and less likely to be seen as adequate. Formal evaluation is becoming even more important as management strategies, such as total quality management (TQM) and continuous quality improvement (CQI), are adopted--strategies that rely on gathering and using data for measuring service quality. Although programme jargon such as TQM and CQI may change in the future, it is likely that the evaluation process inherent in these approaches will continue to be an important management tool for deciding on the allocation of scarce resources.
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