CSM-Inpatient by qingyunliuliu


									                                                               Mission: UAMS Medical           CARE VALUES
                                                               Center provides patient         Compassion
                                                               centered, cost effective CARE   Positive Attitude
                                                               through a healthcare system     Respect
                                                               committed to education and      Excellence

        Job Title: Clinical Service Manager                    Job Description Performance Appraisal
                                                               Employee Name
        Reports to :Nursing Director                           _____________________________

        Performance Areas                                      Overview: Clinical Service Managers(CSMs) have
        I. Guest Relations                                     major responsibility for the implementation of the
        II. Safety and Emergency Preparedness                  vision, mission, philosophy, core values, evidence-
        III. Institutional/Professional Standards              based practice, and standards of the organization, and
        IV. Performance Improvement, EBP, Research             nursing services within their defined areas of
        V. Performs the Role of Nursing Director               responsibility. The CSM has authority to make
        VI. Professional Growth                                decisions in these areas specific to the unit managed
        Qualifications:                                        and has 24 hour accountability for unit operation. The
        *Licensed as a Registered Nurse by the State of        CSM practices within the standards of UAMS, the
        Arkansas.                                              American Nurses Association for Scope and Standards
        * Baccalaueate degree in nursing required; Masters     of Practice, Code of Ethics for Nursing, Nursing’s
        preferred                                              Social Policy Statement, and specialty
        *Membership in a professional nursing organization
        *A minimum of five years of nursing experience,
        preferable in a teaching hospital.
        *Willingness to obtain ANCC certification in her/his

                                           Check appropriate
        Aged Served:                            box(s)
        Neonate less than 30 days
        Infant 30 days - 1yr
        Pediatrics 1yrs - 13 yrs
        Adolescent 13 yrs - 18 yrs
        Adult 18yrs - 65 yrs
        Older adult greater than 65 yrs

               I have read and do understand the description of my position with UAMS Medical Center

                                             Signature                                            Date

03/2010 Clinical Service Manager
        UAMS Medical Center                            Clinical Programs Performance Appraisal
        Job Title: Clinical Service Manager

        Employees Name______________________________ Title_______________________________

        Department__________________________                    SAP #______________________________

        Name_____________________________                       Title__________________             SAP#_______

        Instructions: Performance appraisal will be completed annually for each employee. Each indicator on the job
        description will receive a score of 1-3 based on the assessment of the performance criteria. Each score may
        be determined by percentage, quantity or quality, individually or in combination. A score of two (2) is
        considered to meet the performance criteria. Any score of 1or 3 MUST have a comment by both the
        employee and evaluator. Any score of one (1) requires a comment by the evaluator.

                       1                                 2                                      3
             Meets the standard of             Meets the standards of
                                                                            Meets the standard of performance 95% -
         performance less than 85% of      performance 85% - 94% of the
                                                                                       100% of the time.
                   the time.                           time.
         Performance is not acceptable         Capably and consistently        Clearly and consistently produces
           and falls below standards of    produces work results that meet   outstanding work with results that far
        expectation for the position. Plan all performance standards and    exceed performance standards and job
        of professional development with job requirements of the position. requirements. Demonstrates exceptional
               corrective action for             Commendable effort           initiative, dependability and efforts.
          improvement is required and                                       Demonstrates diligence in continuously
         submitted to the CSM within 14                                         seeking quality and productivity
                       days.                                                               requirements
        Professional Portfolio:
        A professional portfolio and self evaluation must be submitted to CSM within 2 weeks of evaluation by each
        Registered Nurse and includes the following:
        Training Tracker Record for past two years
        Documentation of committee work i.e. Shared Governance
        Documentation of participation in Performance Improvement
        Documentation of community involvement
        Documentation of research study involvement
        Personal Professional Goals and Objectives for the coming year, including
        evaluation of previous years goals and objectives when applicable
        Copy of required BCLS, ACLS, PALS, NRP,TNCC
        Copy of exemplars that reflect your nursing practice and outcome
        Completions of all annual required competencies
        Letters of commendation

        Sources of Evidence: Documentation that will be provided and used for evaluation purposes.
        Source:             Key:     Source:                  Key:       Source:                Key:
        Training Tracker    TTR      Variances                V          Preceptor              PE
        QI Monitors         QI       Patient Satisfaction     PS         IDPOC Meetings         IPOC
        Peer Reviews        PR       Care Cards               CC
        CDF Reviews         CDF R    Documentation            D
        Manager Review      MR       Student Evaluations S E

03/2010 Clinical Service Manager
 UAMS Medical Center                           Clinical Service Manager Performance Appraisal
 Key: S= Self        E= Evaluator
 I. Guest Relations                                                                                           Self    Evaluator
 Supports and demonstrates a guest service and patient rights commitment to internal and external
 customers through adherence to UAMS Guest Relation Service standards and processes.
  Measurement Criteria
 1. Adheres to UAMS Guest Relations Guidelines
 http://www.uams.edu/UH/policy/human resources/hr103.htm
 2. Uses appropriate communication (written and verbal)
 *Uses line of authority when communicating information/problems involving patients/staff. *Communicates accurate and
 complete information. *Listens and initiates feedback to ensure effective communication. *Ventilates frustrations in
 appropriate time, place and manner. *Practices discretion (confidentiality) in information shared with patients and peers

 3. Availability/Responsiveness
 *Adheres to department attendance standards by: Observing assigned work hours, reports promptly to duty notifying
 department of scheduled, unscheduled absences and tardiness per policy. *Responds to staffing needs of unit.

 4. Respectful of others
 *Respects patient's privacy and confidentiality. *Treats patients and visitors with care, compassion and dignity. *Promote
 positive image of University Hospital. *Assist other staff members in completing job assignments. *Being cooperative and
 pleasant to co-workers. *Respond to co-workers needs.
 5. Takes proactive approach toward customers.
 *Shows courtesy toward visitors by being pleasant and helpful on the telephone or in person (introducing self, making eye
 contact and calling others by name). *Assist patients and visitors with information and/or solutions to problems. *Helping or
 offering assistance to patients, visitors and staff who look confused.


 II. Safety, Infection Control and Emergency Preparedness Score of 1 or 2 only                                Self    Evaluator
 Assists in maintaining a safe environment of care by actively participating in all hospital and department
 safety measures and reporting any hazardous or unsafe practices.
 Measurement Criteria
 1. Adheres to UAMS Patient Safety Plan
 2.Complies with safety instructions
 Adheres to safety standards related to equipment and electrical safety, infection control and OSHA requirements.
 *Knowledgeable regarding role in emergency codes and procedures. *Completes all mandatory competency requirements
 3. Observes safe work practices
 *Assumes responsibility for personal safety by using proper body mechanics, universal precautions and proper handling of
 hazardous materials. *Responds in emergency situations.

 4. Provides input on safety issues
 5. Promotes a safe work environment
 *Intervenes in unsafe situations by taking action. *Documents in PSN System


03/2010 Clinical Service Manager
 UAMS Medical Center                             Clinical Service Manager Performance Appraisal

 III. Institutional Professional Standards            Score of 1 or 2 only                                   Self   Evaluator

 Adheres to and maintains current knowledge of all Clinical Programs policies and procedures
  Measurement Criteria:
 1. Adheres to UAMS Code of Conduct
 2. Adheres to Admin Guide, Clinical Programs and Department policies
 3. Adheres to Clinical Programs and Departmental dress code standards
 http://www.uams.edu/uh/policy/human resources/hr204.htm

 *Complies with dress code policy including wearing UAMS ID badge and demonstrates a professional image in appearance
 4.Works effectively with team/work groups and others to fulfill UAMS Mission
 *Serves as resource person to support department members in performance of duties
 5. Adopts practices to improve work processes, enhance guest satisfaction and reduce wastes and costs.
 *Notifies appropriate staff members of problems requiring prompt intervention. *Identifies and reports areas where cost
 effectiveness can be implemented within the department. *Utilizes department supplies, equipment and services
 6. Protects confidential information
 *Adheres to UAMS policy in managing all communications and handling of health care records to prevent improper
 disclosures and to protect patient confidentiality. *Protects health information that is used/disclosed in any form
 (electronically, paper or oral) in practice.

 IV. Process Improvement
                                                                                                             Self   Evaluator
 Source of Evidence: TTR, PR, CDFR, MR, V,QI, PE, D
 Measurement Criteria
 1.Participates in ongoing hospital performance assessment and process improvement.
 * Helps to develop action plans for improvement. Participates in FEMA, RCA as requested. Reviews Joint Commission CSR
 for areas of responsibility.

 2. Ensures continuing department performance assessment and process improvement.
 * Reviews QI data to obtain unit performance and is actively engaged.
 3. Creates work processes to enhance customer satisfaction and reduce waste.
 * Reviews unit performance from Press Ganey and encourages Green programs.
 4. Reviews trends/issues from patient safety net; takes action as appropriate.
 * Reviews actions from Manager for appropriateness.

03/2010 Clinical Service Manager
 UAMS Medical Center                                Clinical Service Manager Performance Appraisal
 V. Performs the Role of Clinical Service Manager
                                                                                                                   Self   Evaluator
 V.1. The CSM demonstrates a commitment to the personal and professional development of the UAMS
  Measurement Criteria
 1. Develops, maintains, and evaluates an environment that empowers and supports the professional nurse: (ensures staff
 implementation of evidence based practices, monitors and follows up with staff participation and educational activities,
 mentors staff communication skills with patients, families, and healthcare team members, maintains unit clinical
 competencies in collaboration with CNS/NC, ensuring compliance with regulatory bodies, and supports staff participation in
 Professional Nursing Organization).

 2. Systematically evaluates the quality and effectiveness of the nursing practice for the staff related to patient population:
 (Participate in the orientation process, collaborates with the preceptor/CNS/NC to individualize the orientation process, serve
 as mentor, resource, and preceptor for new CSMs. NC, andCNS).


 V.2. The CSM demonstrates a commitment to customer service at UAMS.
                                                                                                                   Self   Evaluator

 1. Develops, maintains, and evaluates an environment that is dedicated to achieving the customer service expectations of
 the patient/family: (evaluate patient satisfaction results as indicated, develops action plan as needed, utilizes input from
 patients/families, physicians, peers, staff, and CNS/NC to adapt environment to meet the patient's needs, participates in
 patient rounding to analyze performance in real time to facilitate prompt patient satisfaction recovery as neeeded).

 2. Decisions and actions are based on ethical principles: (resource to staff accessing the medical ethics committee,
 facilitates ethical discussions regarding patient care issues and involves appropriate health team members, assures
 compliance with "Patient Bill of Rights".)

 V.3. The CSM demonstrates a commitment to the financial goals at UAMS.
                                                                                                                  Self    Evaluator

 1. Develops, maintains, and evaluates unit based processes to facilitate the efficient delivery of care: (provides written
 analysis and justification for budgetary variances, collaborates with Director to develop written recommendations for unit
 staffing matrix, monitors staffing matrix daily to ensure staffing is appropriate for census and acuity, holds staff accountable
 to the staffing matrix and unit budget, evaluates unit needs for capital equipment and prepares formal justification, manages
 material/human resources in compliance with organizational standards, continuously analyzes data related to employee
 attendance and turnover and developes plan as appropriate).

 2. Develops, maintains, and evaluates interdepartmental systems that support the effective delivery of care across the
 continuum: (monitors length of stay and collaborates with interdisciplinary team for improvement opportunities, promotes and
 facilitates unit based interdisciplinary discharge planning, facilitates unit specific projects to monitor and develop action plans
 to improve patient outcomes).


03/2010 Clinical Service Manager
 UAMS Medical Center                        Clinical Service Manager Performance Appraisal
 V.4 The CSM demonstrates a commitment to quality patient care at UAMS.                                          Self   Evaluator

 1. Evaluates progress in relation to the attainment of patient outcomes: (collaborates with CNS/NC to identify the staff's ability
 to achieve outcomes related to quality patient care, maintains accountability for outcomes and transforms strategies into

 2. Developes, maintains, and evaluates patient and staff data collection systems and processes to support the practice of
 nursing and delivery of patient care: (utilizes patient safety net, variance reports, PI indicators, and staff observations to
 monitor and facilitate a safe work environment, monitors quality of nursing care and documentation through direct
 observation and QI/PI data, collaborates with staff and CNS/NC to identify practice/plan of care modifications to address
 changes in population and patient length of stay goal, monitors the implementation and adherence to appropriate protocols
 for the patient plan of care by QI monitors, feedback from CDFs and chart reviews, utilizes unit specific data to formulate unit
 based QI projects, resource to staff in complex patient issues, administers medications according to departmental/unit policy,
 ensures compliance with medication administration policy).

 3. Develops, maintains, and evaluates information systems and processes that promote desired patient-defined,
 professional, and unit specific outcomes: (Collaborates with CNS/NC to define population-specific goals and outcome targets,
 analyzes and plans improvement strategies for outcome data reflected on unit key metrics).

 4. Supports research and its integration into nursing and the delivery of healthcare service; (facilitates
 data collection for research/evaluation, activley supports project and initiatives from the Center of
 Nursing Excellence, supports and participate in research projects for research day).


 V.5 The CSM demonstrates a commitment to personal and professional growth.                                      Self    Evaluator

 1. Evaluates personal performance based on professional practice standards, relevent statutes, rules and regulations, and
 organizational criteria; (developes and implements action plan to strengthen practice and leadership behaviors based on
 feedback from staff, CSM, other team members, and Director, effectively critiques his/her job performance, attains and
 maintains national certificication in area of clinical expertise or administration within two years of attaining role, hold
 membership and activley participates in nursing organization, developes written goals and plan of action to enhance
 expertise in management role and patient specialty, evaluates outcomes of goals, and objectives annually).

 2. Maintains and demonstrates current knowledge to advance nursing practice; (facilitates the development/review/revisons
 of standards of care, serves as a resource for staff and peers in interpreting and utilizing standards of care, policies, and
 procedures, communicates changes and practice standards and policies, maintains compliance of standards and policies by
 providing staff feedback on performance, identifies nursing needs in crisis situations and performs clincial functions as
 necessary including support of familys and staff, participates in professional/institutional development, completes 48 hours of
 staff development in continuing education activity annually).

 3. Accountable for providing a professional environment; (facilitates staff participation in formal and informal educational
 activities in clinical experiences that will promote professional growth, demonstrates understanding and ability to initiate the
 disciplinary process, developes strategies to recruit and retain, mentor, educate, and promote meaningful work to maximize
 job satisfaction and professional development of staff, role models positive behavior during periods of change/increased
 workload/stress, provides feedback in a private constructive manner).


 VI. Professional Growth
                                                                                                                 Self    Evaluator
 Maintains Current Knowledge in the Administration of Healthcare Organizations to Advance Nursing
 Practice and Enhance for Professional Growth

 1. Seeks experiences to advance skills and knowledge in areas of responsibilities. * Participates in Continuing
 education and completes 48 hours annually of staff development activities in professional/institutional advancement.

 2. Demonstrates a commitment to ongoing professional development. * Obtains and maintains a national certification in
 area of expertise. Participates in providing on-going leadership education.

 3.Networks with colleagues to share ideas. * Holds membership in a professional nursing organization and takes an active
 part in the organization by presentations or holding an office or a chair.


03/2010 Clinical Service Manager
UAMS MEDICAL CENTER                                                                                                               CLINICAL PROGRAMS
Clinical Service Manager                                                                                                      PERFORMANCE APPRAISAL

                                                                                             SECTION   TOTAL
                                                                                     SECTION   MAX   FROM EACH   VALUE                           SECTION
      Rate Employee's Overall Performance                                             VALUE POSSIBLE  SECTION    WEIGHT                           SCORE
  I. GUEST RELATIONS (25%)                                                             125      3        0     41.66666667                          0
 II. SAFETY AND EMERGENCY PREPAREDNESS (10%)                                              50                2                        25             0
 III. INSTITUTIONAL/PROFESSIONAL STANDARDS (5%)                                           25                2            0          12.50           0
IV. PROCESS IMPROVEMENT (5%)                                                               25                 3          0        8.3333333         0
 V. PERFORMS ROLE OF Clinical Service Manager (50%)                                        250               15          0       16.6666667         0
VI. PROFESSIONAL GROWTH (5%)                                                               25                 3          0        8.3333333         0
 □ Section Value - multiple 500 points by the assigned percent value for the section.                                        OVERALL SCORE                 0
 □ Section Maximum Possible - multiply the maximum possible score of 2 or 3 by the total number of criteria.
 □ Section Total - total the scores achieved for each criteria based on employee’s performance.                              RECOMMENDED
 □ Value Weight - divide the Section Value by the Section Maximum Possible.                                                  MERIT INCREASE
 □ Section Score - multiply the Section Total by the Value Weight.

  □ Signatures

                  EMPLOYEE’S SIGNATURE / DATE                                                                     EVALUATOR’S SIGNATURE / DATE

                                         I acknowledge that this performance appraisal was discussed with me.
                                                   Signature does not necessarily mean agreement.

03/2010 Clinical Service Manager
03/2010 Clinical Service Manager
          UAMS Medical Center                                                   Professional Development Plan
          Job Title Clinical Service Manager

          Name____________________________                             Date:_________________________

          I. Career Goals

          II. Development Action Plan
          Describe the specific actions that you expect to take during the next year to achieve your specific goals
          inclusive of target dates

          Employee's Signature_____________________________                      Date:_________________

          Reviewer/ Title                                                          Date:

03/2010 Clinical Service Manager
       UAMS Medical Center                                Professional Development Plan
       Job Title Clinical Service Manager

       Performance Results for Goals and Objectives for an Annual Appraisal Period



       Dates: From__________________________            To_________________________________

                     Objectives                                Results                              Summary of

                                                                                                                  Not fully Met
                                                                                                      Fully Met

                                                                                                                                  Not Met

03/2010 Clinical Service Manager

10/06/07 RN III Proficient
Approved by SOP 11/20/07

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