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8/12/2019 Report Controlling
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Controlling
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Controlling or evaluating is anon-going function ofmanagement which occursduring planning,organizing anddirective activities.
Opens opportunities forimprovement and compares
performance against set standards.
Controlling
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Reasons for Conducting
Evaluation
1. Evaluation ensures that quality nursing careprovided.
2. It allows for the setting of sensible objectives andwith men
3. It provides standars for establishing comparisons.4. It promotes visibility and a means for the
employees to monitor their own performance.5. It highlight problems related to quality care and
determines the areas that require priority
attention.6. It provides an indication of the costs of poorquality.
7. It justifies the use of resources.8. It provides feedback for improvement.
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Evaluation Principle
1. Must be based on the behavioral standars of performancewhich the position requires.
2. There should be enough time to observe employees behavior.
3. The employee should be given a copy of the job description,performance standars and evaluation.4. The employees performance appraisal should include both
satisfactory and unsatisfactory results with specific behaviorinstnces to exemplify there evaluative comment.
5. Areas needing improment must be prioritized to help the
worker upgrade his/her performance.6. Should be scheduled and conducted at a covineint time for
the rater and the employee under evaluation in a pleasantsurrounding and with ample time for discussion.
7. Perceived and accepted positively as a mean of improvingjob performance.
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The evaluation tool should be OBJECTIVE, RELIABLEand SENSITIVE.
Objectivity means free from bias.
Reliability- accuracy or precision of the tool suchthat it will produce the same results if administeredtwice.
Validity-relevance of the measurement to theperformance of the employee while sensitivity meansthe instrument can measure the fine lines of
differences among the criteria being measured.
Characteristics of an
Evaluation tool
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Basic Components of the
control process
1. Establishment of standards, objectives and methodsfor measuring performance
2. Measurement of actual performance3. Comparison of results of performance usingstandards and objectives and identifying strengths
and areas for correction and/or improvement4. Action to reinforce strengths or successes
5. Implementation of corrective action as necessary
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Establishments of Standards
for measuring Performance
Standards onstructure
-focus on thestructure or
management
system used bythe agency todeliver care.
Process standards-decisions andactions of the
nurse relative tothe nursing
process which arenecessary toprovide goodnursing care.
OutcomeStandards
-measures theresults of care
provided in terms
of changes in thehealth status ofclients served.
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Establishment of Objectives
and Methods
Measurable criteria or objectives must bedeveloped to evaluate process and outcome.
The most commonly method used are taskanalysis and quality control.
Quality control refers to the activities andtechniques employed to achieve and maintain the
quality of a product, service or process.
Tasks analysis uses tools such as time studies andchecklist.
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Measuring Actual
Performance Measurement of performance is an on-
going, repetitive process with the actual
frequency dependent on the type of
activity being measured.
It may be scheduled advance, may be done
periodically but unannounced intervals or
may occur at random.
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Comparing Results of
performance with Standards and
Objectives
If the performance matches the
standards and objectives, managers areassured that the needs of patients aremet.
If performance is contrary to standards
and objectives, necessary action areapplied to improve performance.
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Reinforcing Strengths or Successesand Taking Corrective Action as
Necessary
Positive feedback stimulatesmotivation, consistently high
performance and growth of the
employee. Corrective actions
are applied to improveperformance.
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Responsibility of the
Head/Senior Nurse Being at the first level of supervision, the Head / Senior Nurses
are in the best position to know whether their staff nurses
perform satisfactorily at work. Their influence has an impact on
promoting quality care to patients.
They have the responsibility to instruct subordinates regarding
the appropriate methods and procedures in providing nursing
care.
They should inform the staff of the likely causes of errors or
defects and preventive measure necessary.
They should initiate and / or facilitate any steps necessary toimprove methods, equipment, materials and conditions in the
work area for which they are responsible.
The feeling of responsibility to render quality performance
must be instilled in all employees for them to follow agreed
upon written procedures and use materials and equipment
correctly as instructed
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PERFORMANCE
APPRAISAL
It is a control process in which a
employees performance is evaluated
against standards.
is the most valuable tool incontrolling human resources and
productivity.
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Improve communication between
supervisors and employees and reach anunderstanding on the objectives of the job.
Establish standards of supervisory
performance.
Discover the aspirations of the
employees and reconcile these with the
goals of the institution.
Provide employee recognition foraccomplishments.
Inform employees where they stand.
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FACTORS CONTRIBUTING TO AN EFFECTIVEPERFORMANCE APPRAISAL SYSTEM
1. Compatibility between criteria for individualevaluation and organization goals.2. Direct application of the rated performance to
performance standards and objectivesexpected of the worker
3. Deployment of behavioral expectations which
have been mutually agreed upon by both therater and the worker.
4. Understanding the process and effectiveutilization of procedure by the rater
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5. Rating of each individual by the immediatesupervisor
6. Concentration on the strengths and weakness toimprove individual performance
7. Encouragement of feedback from the ratedemployees about their performance needs and
interests.8. Provision for initiating preventive and corrective
action and making adjustments to improveperformance.
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Methods of Measuring
Performance
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Essay
The appraiser writes a paragraph or more about theworkersstrengths, weakness and potentials.
Essays appraisals carry significant weight on thepresumption that an honest statement from someonewho knows the person well is valid.
Checklists
A checklist is a compilation of all nursing performancesexpected of a worker. The appraisers task is to mark
the appropriate column whether the worker does ordoes not show the desired behavior.
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RankingIn simple ranking, the evaluator ranks the
employees according to how he or she fared withco-worker with respect to certain aspects ofperformance or qualifications.
Rating Scales
A rating scale includes a series of itemrepresenting the different task or activities in the
nursesjob description or the absence or presenceof desired behaviors and the extent to whichthese are possessed.
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Forced choice Comparison
In this method, the evaluator is asked to choose the
statement that best describes the nurse beingevaluated. The items are so grouped that evaluator is
force to choose from favorable as well as unfavorable
statements and to counter the tendency towards
leniency by some evaluator.
Anecdotal Recording
It describes the nursesexperience with a group or aperson, or in validating technical skill and
interpersonal relationship.
The anecdotal records should include
1. A description of the particular occasion
2. A delineation of the behavior noted includinganswers to the question who, what, when, and
how
3. The evaluators opinion or assessment of the
incident or behavior
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WHAT IS QUALITY
ASSURANCE
It is a process of evaluation that is applied to thehealth care system and the provision of health care
services by health workers.
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TOTAL QUALITYIMPROVEMENT
-Is a way to ensure customersatisfaction by involving all employees
in the improvement of the quality of
every product or service.
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Is a process of
continuously improving a
system by gathering data
or performance and usingmultidisciplinary team to
analyze the system,
collect measurements,
and propose changes.
Continuous QualityImprovement
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WHAT IS QUALITYASSURANCE AND
PERFORMANCE EVALUATION?
Performance Evaluation-focuses on the worker. It asks questions about
how well the worker satisfies the requirements of his or her jobwithin the organization.
Quality Assurance
-focuses on the care and service the patientreceives than on how well the professional performs the dutiesthe duties that the position requires.
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Several methods:Concurrent and retrospective
patient care auditsPatient care profile analysisPeer reviewQuality circles
Quality Assurance Methods
-purpose is to measure andimprove the quality of nursing delivered in the
agency.
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Developing Quality
Assurance Criteria
Structure Approach
includes physicalsetting,
instrumentalitiesand conditionsthrough whichnursing care isgiven such as the
philosophy andobjectives, thebuilding,organizationalstructure, financialresources, and
equipment
Process Approach
includes the stepsin the nursing
process incompliance withestablishedstandards ofnursing practice.
Outcome Approach
identifiesdesirable
changes in thepatients health
status such asmodification ofsymptoms, signs,
knowledge,attitudes,satisfaction, skilllevel, andcompliance withthe treatment
regimen.
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Nursing Audit Committee
A nursing audit is composed of arepresentative from all levels of thenursing staff:
A member of the training staff
Supervising Nurse
Head/Senior Nurse
Staff Nurse
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Patient Care Audits
Concurrent Audit
1. Is one in which patientcare is observed and
evaluated. It is giventhrough:
2. A review of the patientscharts while the patientsare still confined in thehospital.
3. Observation of the staffas patient care is given.
4. Inspection of patientsand/or observation ofthe affects of patientcare where the focus ison the patient.
Retrospective Audit
-Is one which patientcare is evaluated
through A review of discharged
patients charts;
Questionnaires sent to orinterviews conducted ondischarged patients.
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Utilizationof Results
- The Nursing Staff in the
unit is given a feedback onthe results of the quality
assurance study.
-Positive Feedback reinforces
desirable performance.
Consistent positive findingsdeserve a commendation
from the nursing service.
-Negative Feedbacks should
tactfully be conveyed in a
face-to-face situation so that
assessment results may
easily be clarified.
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Control of Resources
-Part of the control process is the periodic reviewof the utilization of materials and supplies in thevarious nursing units.
-Requisitions of and/ or stocking a large numberof supplies and materials should be avoided to
prevent pilferage, misuse, or spoilage.
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DISCIPLINE
-Discipline meant rigid obedience to rules and
regulations, the violation of which resulted inpunitive actions in the past.
-Discipline is regarded as constructive and
effective means employees take personalresponsibility for their own performance and
behavior.
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Disciplinary ApproachesThis should include a set of
disciplinary policies and procedures, a uniformapplication of discipline rules, a disciplinary
committee, and an orientation program for allnew employees were expectations ofappropriate performance and behavior areemphasized. There must be continuouscommunication to all employees regardingchanges in personnel and discipline policies.
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Disciplinary Action
Any employee charged for breach of
the rules and regulations, policies, norms of conductshall be given due process.
-Should be progressive in nature such as
counseling and oral warning, suspension and
dismissal
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Counseling and Oral warning-The employee is given a fair chance to air
his/her side-the relevant facts are analyzed and evaluatedagainst his/her past performance.
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Written warning-it is preceded by an interview similar to the oral.-the employee must be told after the interview
that he/she will be given a written warning.-includes statement of the problem, identificationof the rule which was violated, consequences of
continued deviant behavior, the employeescommitment to take corrective action, and any
follow up action to be taken.
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Suspension
-given after an evidence of oral and written
warnings.-this is applied when the management feels
that the employee can still be rehabilitated.
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Dismissal-the Disciplinary Committee should be very sure
that the cause for dismissal conforms with thecriteria of a major discipline violation as
contained in the policy manual.
-invoked only when all other disciplinary
efforts have failed.