Consultative_Workshop_on_Development_of_an_Effective

2009

Dr. Shabnum Sarfraz

SP-39

12/21/2009

Consultative Workshop on Development of an Effective

Performance Management Mechanism for Nurses

2 Consultative Workshop SP-39

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 Principal SON Mayo Hospital

2. Mrs. Nasreen Butt Nursing Supdt, Lady Aitchison Hospital, LHR

3. Mrs.Sajida Furshid Deputy Chief Nursing Suptt., Sir Ganga Ram

Hospital LHR

4. Mrs. Munawar Sultana Deputy Chief Nursing Suptt., PIC, LHR

5. Arshad Rashid Deputy Director PDSSP

6. Mrs. Sharaf Sultana Deputy Chief Nursing Suptt., Mayo Hospital, LHR

7. Dr. Ayesha Nauman Deputy Director System & HRD, FMS Shadman

8. Mrs. Nargis Butt Director General Nursing / Principal, Lady

Aitchison Hospital PGCN, LHR

9. Mrs. Tasneem Khanum Nursing Suptt., Children Hospital, LHR

10. Mrs. Shahnaz Akhtar Zaidi Controller Nursing Examination Board

11. Mrs. Ishrat Ishaq Principal SON, General Hospital LHR

12. Mrs. Razia Bano Nursing Suptt., General Hospital, LHR

13. Syed Qurban Ali Shah APO, PDSSP

14. Mrs. Kausar Praveen Principal , SON, Jinnah Hospital, Lahore

15. Mrs Irshad Javed Director Nursing Education, Development and

Clinical Services, Saida Waheed FMH College of

Nursing

16. Ms. Sarosh Sikander Saida Waheed FMH College of Nursing

Facilitator: Dr Shabnum Sarfraz, Health Human Resource Management,

Specialist


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.


Session Plan of the Consultative Workshop:

Time Session

9.30 -10.00 am Recitation from Quran Introduction of particpants Workshop Orientation

10.00 -10:30 am Performance Management System- An overview

10:30 – 11:00 am Tea Break 11:00 – 11.45 am Review of Existing Performance Evaluation Mechanisms for Nurses in

Punjab 11:45 - 12:30 pm Feedback on how to improve the Performance Management for

Nurses 12:30 - 12:50 pm Finalizing Recommendations 12:50- 1:00 pm Concluding Remarks

1:00 – 1:30 pm Lunch

Main Focus: Drawbacks in the ACR Form

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 .


Main Focus: Problem with the existing Performance

Evaluation Mechanism

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 the

Performance Management Mechanism of Nurses

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


Annexure: Participant Manual for gathering feedback during the

workshop

Facilitator: Dr Shabnum Sarfraz Healthcare Human Resource Specialists SP39

TAMA-PDSSP

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


Name:

Designation:

Working for the department of:

Contact Details:

Address:_____________________________________

___________________________________________

_______ Mob No: ________________________

E Mail Address: ____________________


Session Plan Monday 21

st Dec 2009

Time: 9.30 am – 1pm

Time Session

9.30 -10.00 am Recitation from Quran Introduction Workshop Orientation

10.00 -10:30 am Performance Management System- An overview

10:30 – 11:00 am Tea Break 11:00 – 11.45 am Review of Existing Performance Evaluation Mechanisms for Nurses in

Punjab 11:45 - 12:30 pm Feedback on how to improve the Performance Management for

Nurses 12:30 - 12:50 pm Filling in of questionnaires

12:50- 1:00 pm Concluding Remarks

1:00 – 1:30 pm Lunch


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 TO SOME EXTENT NO


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?

_____________________________________

_____________________________________


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?

_____________________________________

_____________________________________


11. Do you get any praise between appraisals?

_____________________________________

_____________________________________ Formats of Appraisal

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

_____________________________________

_____________________________________

_____________________________________

_____________________________________ Measuring Performance

13. 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?

_____________________________________

_____________________________________


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:

_____________________________________

_____________________________________

_____________________________________

_____________________________________


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

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________


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:

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________


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

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________

Consultative_Workshop_on_Development_of_an_Effective

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