Consultative_Workshop_on_Development_of_an_Effective

2009 Consultative Workshop on Development of an Effective Performance Management Mechanism for Nurses

Dr. Shabnum Sarfraz SP-39 12/21/2009

Summary: Date:

Monday, 21st December 2009

Workshop Title:

Development of an Effective Performance Management Mechanism for Nurses

Convened by:

(TAMA) Technical Assistance Management Agency (PDSSP) The Punjab Devolved Social Services Program

Venue:

Executive Hall, MPDD, Upper Mall, Lahore

Participants: 1. Mrs. Neelofar Shahzad 2. Mrs. Nasreen Butt 3. Mrs.Sajida Furshid 4.

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Mrs. Munawar Sultana Arshad Rashid Mrs. Sharaf Sultana Dr. Ayesha Nauman Mrs. Nargis Butt

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15.

Mrs. Tasneem Khanum Mrs. Shahnaz Akhtar Zaidi Mrs. Ishrat Ishaq Mrs. Razia Bano Syed Qurban Ali Shah Mrs. Kausar Praveen Mrs Irshad Javed

16. Ms. Sarosh Sikander Facilitator:

Principal SON Mayo Hospital Nursing Supdt, Lady Aitchison Hospital, LHR Deputy Chief Nursing Suptt., Sir Ganga Ram Hospital LHR Deputy Chief Nursing Suptt., PIC, LHR Deputy Director PDSSP Deputy Chief Nursing Suptt., Mayo Hospital, LHR Deputy Director System & HRD, FMS Shadman Director General Nursing / Principal, Lady Aitchison Hospital PGCN, LHR Nursing Suptt., Children Hospital, LHR Controller Nursing Examination Board Principal SON, General Hospital LHR Nursing Suptt., General Hospital, LHR APO, PDSSP Principal , SON, Jinnah Hospital, Lahore Director Nursing Education, Development and Clinical Services, Saida Waheed FMH College of Nursing Saida Waheed FMH College of Nursing

Dr Shabnum Sarfraz, Health Human Resource Management, Specialist

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Background/Purpose of the Workshop: The outcomes of the study completed under PDSSP-TAMA – SP11: Healthcare Manpower Planning and Management – highlight a number of important issues for the human resource development in the health department. Lack of an effective Performance Management Mechanism for Nurses was one such issue The objective of this workshop was to gather feedback from the stakeholders on the existing performance management mechanism for nurses.

It was anticipated that the development and implementation of a standardized, transparent and objective Performance Management Mechanism for all cadres of nurses in Punjab will promote excellence in individual nursing practice, continuous quality professional development and, ultimately, excellence in the programs and services provided by the professional nurse.

Objectives of the meeting: The objectives of the meeting were: 1. To review the current Performance Management Mechanism for all cadres of nurses in Punjab.

2. To review the ACR Form as a valid and reliable tool.

3. To formulate and prioritize recommendations to be incorporated in the TORs for development of an effective Performance Management Mechanism for Nurses.

Expected output of the meeting: A detailed evaluation of ACR Form to assess the extent of its validity and reliability, as a performance appraisal tool, for nurses working in the clinical, administrative and academic settings.

TA requirements by the senior nurse stakeholders for the development of ToRs for undertaking consultancy assignments for meeting those TA needs.

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Session Plan of the Consultative Workshop: Time 9.30 -10.00 am

10.00 -10:30 am 10:30 – 11:00 am 11:00 – 11.45 am 11:45 - 12:30 pm 12:30 - 12:50 pm 12:50- 1:00 pm 1:00 – 1:30 pm

Session Recitation from Quran Introduction of particpants Workshop Orientation Performance Management System- An overview Tea Break Review of Existing Performance Evaluation Mechanisms for Nurses in Punjab Feedback on how to improve the Performance Management for Nurses Finalizing Recommendations Concluding Remarks Lunch

Main Focus: Drawbacks in the ACR Form   

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ACR forms are of generalized nature to be used for appraisal of all types of staff.

These forms mainly contain personal attributes which can only be graded subjectively.

These are also not useful for the performance evaluation against any particular assigned position because only a few non-specific facets pertaining to the actual responsibilities/duties of the assesses.

Besides that no criteria is available to grade against these responsibilities and these too are subject to personal judgment of the reporting officer.

They very well serve the purpose of making employees happy with some sense of security to the assessor.

First-hand observations are impossible because appraisal is done by those who don't routinely observe nurse-patient encounters. A supervisor commonly relies on second-hand information Nurses' job descriptions are rarely specific enough to form the basis of measuring an individual's performance.

The ACR tool is not valid because there are no predetermined standards for evaluation It does reflect overall behavioral performance but to a limited extent and allows a subjective analysis The ACR form is too generic .

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Main Focus: Problem with the existing Performance Evaluation Mechanism 

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JDs were neither distributed at all levels of care nor notified, hence could not be practiced in true spirit and were unable to achieve the objectives of improving the health care delivery.

The staff in general is performing conventional duties or any other duty assigned by the higher offices.

There is no check on a Senior/MS who doesn’t initiate or countersign ACR on time Performance appraisal schedule is not defined There are no predetermined standards for comparison JD is not defined The aspect of confidentiality of the ACR form is questioned because the individual him/herself is given responsibility to even purchase the form and submit it- (this should be an institutional effort) There is no central mechanism of keeping the complete ACRs and retrieving them at the time of appraisal Lack of accountability; there is no check on those who don’t submit ACRs There is no structured career progression system; demand and supply of various Nursing positions can be identified but because of a lack of an automated system, there is a huge time lag before any position is filled

Main Focus: Recommendations for improving Performance Management Mechanism of Nurses 

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A JD should be given to each category of health worker so that job holders have a clear understanding of what they must do and what they are expected to achieve.

As people and roles change, so JDs should be reviewed and revised regularly.

JD to be comprehensive and clearly mention objectives of the position, qualification, major duties, working hours, deliverables, working domain, contact numbers for on call duty, hierarchical level and declaration of acceptance of JD. There is a need for designing appropriate training packages for different levels and positions in nursing cadre.

Adopting uniform format as far as possible Clear JDs with specific tasks being assigned Provision of formal JDs to all categories Establishing mechanism of regular and systematic revision of JDs in accordance with changing health status and the health needs.

The ACR form should be specific to the job, it should be color coded and have serial numbers. Its contents should be user-friendly

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Annexure: Participant Manual for gathering feedback during the workshop

TAMA-PDSSP

Participant’s Feedback Form Consultative Workshop – Performance Management Mechanism of Nurses

Facilitator: Dr Shabnum Sarfraz Healthcare Human Resource Specialists SP39

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Name:

Designation:

Working for the department of:

Contact Details: Address:_____________________________________

___________________________________________ _______ Mob No: ________________________ E Mail Address: ____________________

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Session Plan Monday 21st Dec 2009 Time: 9.30 am – 1pm Time 9.30 -10.00 am

10.00 -10:30 am 10:30 – 11:00 am 11:00 – 11.45 am 11:45 - 12:30 pm 12:30 - 12:50 pm 12:50- 1:00 pm 1:00 – 1:30 pm

Session Recitation from Quran Introduction Workshop Orientation Performance Management System- An overview Tea Break Review of Existing Performance Evaluation Mechanisms for Nurses in Punjab Feedback on how to improve the Performance Management for Nurses Filling in of questionnaires Concluding Remarks Lunch

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REVIEW OF THE PRESENT PERFORMANCE MANAGEMENT PROCESS 1) Have you seen the revised job descriptions for Nurses?

YES

TO SOME EXTENT

NO

2) Had there been major changes in the ACR Framework since the last Job Descriptions have been reviewed?

YES

TO SOME EXTENT

NO

3) Do you think the nurses are provided with their Job Descriptions?

YES

TO SOME EXTENT

NO

4) Are you aware of the link between the Job Descriptions and the Appraisal System?

YES

TO SOME EXTENT

NO

5) Have you received any training on how to conduct Performance Appraisals?

YES

TO SOME EXTENT

NO

6) Do you feel that the current Performance Management System improves the motivation and commitment of the Nurses?

YES

TO SOME EXTENT

NO

7) Are the Nurses being regularly counseled on their performance?

YES

TO SOME EXTENT

NO

8) Do the Nurses get something positive out of the process?

YES

TO SOME EXTENT

NO

9) Do you give feedback at regular intervals to the nurses?

YES

TO SOME EXTENT

NO

10) Are you clear about the behavioral and professional competencies required for different levels and cadres of nurses?

YES

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TO SOME EXTENT

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The Appraisal System for Nurses-An Overview

1.

What type of appraisal system is in your work place?

_____________________________________ _____________________________________ 2.

How often are you are appraised?

_____________________________________ _____________________________________ 3.

Is the appraisal carried out at regular intervals?

_____________________________________ _____________________________________ 4.

Is there any follow up between appraisals?

_____________________________________ _____________________________________ 5.

How often are you expected to carry out appraisals?

_____________________________________ _____________________________________

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The Objectives of Appraisal

6.

Do you have a main objective when you carry out an appraisal, or participate in one?

_____________________________________ _____________________________________ 7.

Do you feel the purpose of appraising (or participating) in an appraisal, is just a management requirement?

_____________________________________ _____________________________________ Problems of Appraisal

8.

Who participates in your appraisal?

_____________________________________ _____________________________________ 9.

Do you normally enjoy having an appraisal?

_____________________________________ _____________________________________ 10.

Do you get any constructive feedback between appraisals?

_____________________________________ _____________________________________

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Do you get any praise between appraisals?

_____________________________________ _____________________________________ Formats of Appraisal

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You have been asked to join a working party to design a new appraisal form what would you include and why?

_____________________________________ _____________________________________ _____________________________________ _____________________________________ Measuring Performance

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You have probably had to write job descriptions before carrying out the Performance Appraisals? What problem if any you may have?

_____________________________________ _____________________________________ 14.

Can you define job competencies for different levels and cadres of nurses?

_____________________________________ _____________________________________

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Which Departments are involved in the Performance Management for Nurses in Punjab? What is their Role?

S.No

Department

Role & Responsibility

Do you think ACR is a good tool for staff development and performance evaluation? Why?

_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ In your view the biggest problem with the existing Performance Evaluation Mechanism for Nurses is:

_____________________________________ _____________________________________ _____________________________________ _____________________________________ Consultative Workshop SP-39

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In your view how can we improve the performance management mechanism of Nurses?

_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ I recommend the following changes in the existing Performance Management Systems

_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ Identifying criteria against which to measure performance of Nurses Educators

_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ Consultative Workshop SP-39

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Identifying criteria against which to measure performance of Nurse Administrators:

_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ Identifying criteria against which to measure performance of Nurses working in Clinical Setting?

_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ The ACR formats for Nurses should contain the following:

_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ Consultative Workshop SP-39

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As a senior manager/leader, I need to develop the following skills in order to conduct the performance appraisals more effectively:

_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________

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