Demo of Self Employee Performance Review by goq40676

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

                   Clinical Programs
Job Title: NURSING DIRECTOR, QUALITY                                   Job Description Performance Appraisal
Reports to: Chief Nursing Officer                           EMPLOYEE NAME________________________________
                                                                              (Please Print)

Performance areas                                                       Overview
I.     GUEST RELATIONS                                      25%         The Nursing Director has responsibility for development and ongoing evaluation of programs designed to
                                                                        enhance the quality and safety of patient care and the satsifaction of patients and staff within the clinical areas
II.    SAFETY AND EMERGENCY PREPAREDNESS                    10%         where nursing is practiced. This includes development, organization, implementation and maintenance of a
III.   INSTITUTIONAL/PROFESSIONAL STANDARDS                 5%          performance improvment program that will meet departmental, insititutional, community needs and regulatory
IV.    PROCESS IMPROVEMENT                                  5%          requirements. This director is responsible for collaboration with nursing leadership and nursing staff through
                                                                        the shared governance model, to implement initiatives which achieve unit and departmental goals related to
V.     PERFORMS ROLE OF NURSING DIRECTOR                    50%         safety, quality and satisfaction. The Nursing Director for Quality assumes responsibility for integration of
VI.    PROFESSIONAL GROWTH                                  5%          nursing initiatives with other functional areas of the hospital to achieve interdisciplinary quality, safety and
                                                                        satisfaction goals. The Nursing Director practices within the limits of the Nurse Practice Act of the State of
                                                                        Arkansas, adheres to institutional policies, procedures, and standards.

Qualifications
Licensed as a Registered Nurse by the State of Arkansas                 Corporate Compliance
Masters degree in nursing required                                      HIPAA
Membership in a professional nursing organization desirable             Annual Requirements Module
A minimum of five years of nursing experience, preferably in a
teaching hospital
Willingness to obtain ANCC certification in her/his specialty
Ability to communicate with staff, patients, and famililes following
CARE guidelines
Demonstrate leadership capacity and a philosophy compatible with
organizational values                                                   Job Specific Competencies
Effective verbal and written communication skills                       1
                                                                        2
                                                                        3
Ages served:                    (Check appropriate box.)                4
Neonate <30 days                                                        5
Infant >30 days <1yr
Pediatrics >1 yrs <13 yrs
Adolescent <13 yrs - 18 yrs
Adult >18 yrs <65 yrs
Older adult >65 yrs

                                       I have read and do understand the description of my position with UAMS Medical Center.
           __________________________________                                                            ___________________________________
                       EMPLOYEE'S SIGNATURE                                                                                    DATE
UAMS MEDICAL CENTER                                                                      CLINICAL PROGRAMS
Job Title                                                                                PERFORMANCE APPRAISAL


EMPLOYEE'S NAME                                                   TITLE

EMPLOYEE'S
DEPARTMENT                                                        SAP#

EVALUATOR'S
NAME                                                              TITLE                               SAP#


DATE EMPLOYEE                                                                              SCHEDULED
BEGAN PRESENT                                         DATE OF LAST                         APPRAISAL
POSITION                                               APPRAISAL                              DATE



INSTRUCTIONS: A performance appraisal will be completed annually for each employee. Each indicator on the job description will
receive a score of 1 - 5 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 three (3) is consdered to be an average score. When an employee complies with
the performance criteria, a score of 3 should be given. Any score of 1 or 5 requires a comment by the evaluator.




             SCORES:        -1-            -2-              -3-               -4-               -5-

            QUANTITY:      Rarely  Occasionally          Routinely        Consistently         Always
                                      Needs                Meets            Exceeds
             QUALITY: Unacceptable Improvement          Expectations      Expectations      Outstanding
UAMS MEDICAL CENTER                                                                                CLINICAL PROGRAMS
(Job Title) NURSING DIRECTOR                                                                       PERFORMANCE APPRAISAL
                                                                                                   Key: PT =Posttest V=Verbal PR =Peer Review D= Demonstration CEU =
                                                                                                   Continuing Education

I. GUEST RELATIONS                                                                                                    Postest     Verbal   Peer Review   Demo     CEU
                                                                                             SELF     Evaluator      PT      V      PR       D      CEU
Adheres to UAMS Guest Care Guidelines
http://www.uams.edu/uh/policy/human resources/hr103.htm
Uses appropriate communication (written & 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
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.
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.
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.
                                                             GUEST RELATIONS SCORE             0          0
Comments:

II. SAFETY AND EMERGENCY PREPAREDNESS                                                                                Postest    Verbal     Peer ReviewDemo      CEU
                                                                                           SELF      Evaluator         PT           V         PR          D      CEU
Adheres to UAMS patient safety plan
http://www.uams.edu/uh/policy/administration/a406.htm
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 annually.
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.
Provides input on safety issues
Promotes a safe work environment
     *Intervenes in unsafe situations by taking action. *Documents in PSN System
                                                                   SAFETY SCORE            0           0

Comments:
         Approved 7/03
                                                                                                                                                                        3
III. INSTITUTIONAL/PROFESSIONAL STANDARDS                                                                     Postest    Verbal     Peer ReviewDemo      CEU
                                                                                       SELF      Evaluator      PT           V         PR        CEU
                                                                                                                                                   D
Adheres to UAMS Code of Conduct
http://www.uams.edu/adminguide/win04401.html
Adheres to Admin Guide, Clinical Programs and Department policies
http://www.uams.edu/uh/policy/pp-toc.htm
Adheres to Clinical Program 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
Works effectively with team/work groups and others to fulfill UAMS Mission
       *Serves as resource person to support department members in performance of duties
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 appropriately
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.
                                                                    STANDARDS SCORE            0            0        Max Possible score
Comments:

IV. PROCESS IMPROVEMENT                                                                                        Postest     Verbal   Peer Review   Demo     CEU
                                                                                       SELF      Evaluator      PT           V         PR          D      CEU
Participates in ongoing hospital performance assessment and process improvement.
http://www.uams.edu/UH/policy/administration/a601.htm

Ensures continuing department performance assessment and process improvement.
Creates work processes to enhance customer satisfaction and reduce waste.
Reviews trends/issues from patient safety net
Develops, organizes, implements and evaluates nursing quality, safety, and
satisfaction programs.
                                                                                          0           0

Comments:




         Approved 7/03
                                                                                                                                                                 4
V. PERFORMS ROLE OF NURSING DIRECTOR                                                                                   Postest   Verbal   Peer ReviewDemo   CEU
                                                                                               SELF      Evaluator         PT        V       PR        D     CEU
V.1. DIRECTS AND PARTICIPATES IN THE DEPARTMENT OF NURSING/UAMS
                  MEDICAL CENTER ORGANIZATION
Meets with area CSM as a group or individually on an ongoing basis
Documents attendance at 75% of Nursing Leadership meetings
Available for 50% of called peer review meetings
Manages respective division in congruence with goals, objectives and standards of the department/campus
Participates in the functioning of the Department of Nursing as a member of designated Councils, ad-hoc committees, etc.
Interprets and communicates the Nursing Department philosophy and incorporates into practice
Participates in nursing administrative and dept/unit level decision making and strategic planning for the organization
Keeps informed of changing standards and regulations appropriate for each nursing area of responsibility
Assumes responsibility for the Department of Nursing in the absence of the CNO, Patient Care Services
Comments

V.2. FOSTERS A CLIMATE CONDUCIVE TO EDUCATIONAL EXPERIENCE FOR
                     ALL STUDENTS AND STAFF
Participates in the provision of learning experiences for students by acting as a resource
Collaborates with educators and staff in evaluation of students
Provides for administrative, management and leadership experiences for managers, staff and students
Comments:

     V.3. DIRECTS THE UTILIZATION OF THE DEPARTMENT OF NURSING
     GOVERNANCE SYSTEM FOR PROBLEM SOLVING, IMPROVEMENT OF
      NURSING PRACTICE AND EXPLORATION OF ISSUES AND POLICY
                             DEVELOPMENT
Participates as a representative or resource on a council
Fosters staff participation in the governance system
Selects policies and procedures that facilitate achievement of organizational goals
Integrates nursing policies with organizational policies
Comments:




         Approved 7/03
                                                                                                                                                                   5
V. PERFORMS ROLE OF NURSING DIRECTOR                                                                                      Postest   Verbal   Peer Review   Demo   CEU
                                                                                                  SELF       Evaluator     PT        V          PR          D     CEU
        V.4. DIRECTS IMPLEMENTATION OF CLINICAL PROGRAMS AND
                  DEPARTMENT OF NURSING STANDARDS
Refers to manuals to validate policy decisions
Serves as a resource to other departments in policy decisions
Formulates and administers policies and procedures for each nursing division
Participates in completion of annual review of all nursing policies and procedures
Comments:

     V.5. FACILITATES THE ONGOING EVALUATION AND INNOVATION OF
     SERVICES PROVIDED BY ORGANIZED NURSING SERVICES AND THE
                       ORGANIZATION AS A WHOLE
Evaluates quality of nursing care through direct observation and data collection
Utilizes input from patients, families, physicians and peers regarding care received and staff performance
Evaluates the implementation and use of standards of patient care to achieve evidence based outcomes
Initiates the patient complaint reporting system and documents actions taken and outcomes
Collaborates with other disciplines in promoting, planning and implementing optional patient care as defined by evidence based outcomes
Assures assessment of age specific needs for patients
Comments:

  V.6. OVERSEES THE PARTICIPATION IN PLANNING AND MONITORING THE
                    BUDGET FOR DEFINED AREAS
Coordinates budget planning, implementation and monitoring for division in collaboration with CSMs
Implements cost containment practices and evaluates effectiveness
Provides written analysis and justifications for budgetary deviations on a monthly basis
Evaluates needs for capital equipment and prepares formal justification
Assists in development and monitoring of staffing standards utilizing Quadra Med data: Analyze staffing statistics monthly, reviews cost of overtime and
supplemental staffing monthly, assures appropriate staffing levels each shift for acuity/productivity
Responsible for educating managers and staff regarding effective fiscal practices
Solicits input from Medical Directors/Chairmen of Departments for budget planning
Coordinates employee promotions for designated areas
Comments:

    V.7. PROVIDES AN OPPORTUNITY FOR PROFESSIONAL GROWTH AND
                   DEVELOPMENT OF STAFF MEMBERS
Provides the opportunity for discussion and feedback regarding individual developmental needs
Provides a written evaluation of each CSM based on performance expectations
Collaborates with CSMs in the counseling of employees with potential or actual performance problems
Identifies and documents deficits in employee performance and monitors for improvement in behaviors
Facilitates staff development in concert with CSMs
Fosters staff participation in formal and informal educational experiences that will promote professional growth
Communicates employee performance problems to the CNO
Serves as a resource or mentor to other staff/peers for professional development
Comments:
         Approved 7/03
                                                                                                                                                                        6
V. PERFORMS ROLE OF NURSING DIRECTOR                                                                                      Postest   Verbal   Peer Review   Demo   CEU
                                                                                                     SELF    Evaluator     PT        V          PR          D     CEU
  V.8. SERVES AS AN ADVOCATE FOR PATIENTS, EMPLOYEES AND PEERS
Acts as a resource to staff in planning and implementing care for patients with difficult or complex issues
Identifies ethical issues related to unit/patient care and involves health team members in addressing the issues
Provides direction and education to staff on the need to maintain quality care
Collaborates and supports other managers and ADON in the performance of their duties involving resolution of management problems
          V.9. SUPPORTS OTHERS IN THE PERFORMANCE OF DUTIES
Provides feedback in a private and constructive manner
Praises peers on quality job performance
Maintains awareness of changing patterns of care that will affect the present shift or other shift
Provides nurse consultation services
Oversees unit operation and facilitates the use of resources to meet unit needs
Comments:

        V.10. USES CONSTRUCTIVE FEEDBACK TO IMPROVE PRACTICE
Accepts constructive feedback and takes corrective actions when needed
Completes annual self evaluation and returns to CNO, Patient Care Services by due date
Develops annual written goals and plan of action to enhance practice and meet career goals and submits with annual self evaluation
Comments:

                 V.11 PARTICIPATES IN THE RESEARCH PROCESS
Completes surveys and data collection forms for research evaluation projects
Facilitates data collection for research/evaluation projects conducted
Assures practice changes occur only after current literature/research findings are incorporated into practice standards
Supports, participates in and/or designs nursing research
Comments:

          V.12. PARTICIPATES IN QUALITY IMPROVEMENT ACTIVITIES
Keeps informed of quality improvement activities and aspects of care being reviewed
Communicates unit quality improvement concerns/issues to QI manager/designee
Recognizes actual legal/risk management issues, reports to and seeks assistance for potential problems
Assist department QI manager with analysis of annual data to be used in determining direction for improvement
Comments:




         Approved 7/03
                                                                                                                                                                        7
V. PERFORMS ROLE OF NURSING DIRECTOR                                                                                   Postest    Verbal     Peer ReviewDemo        CEU
                                                                                              SELF       Evaluator       PT           V         PR          D        CEU
         V.13. PARTICIPATES IN RECRUITMENT/RETENTION OF STAFF
Interviews and appoints qualified staff
Appoints candidates to fill positions, according to hiring process
Fosters an environment that enhances productivity
Reviews turnover rate quarterly and discusses with CSM
Keeps staff current on intra-and interdepartmental changes
Fosters a unit environment in which both staff and patient problems may be expressed and solved as they occur and while they are relevant
Collaborates with CSMs upon request regarding appointments to unit positions
Serves as a preceptor for newly appointed Nursing Directors/CSMs

                                                  ROLE PERFORMANCE SCORE                         0            0                   5
                                                                                                                       Max. Score Possible 0                    0
Comments:

VI.                   PROFESSIONAL GROWTH                                                                               Postest     Verbal   Peer Review   Demo       CEU
Criteria attached                                                                             SELF       Evaluator       PT           V         PR          D        CEU
Holds membership in a nursing organization
Participates in organization
Takes active part in organization, such as committee chair or office
Obtains and maintains national certification in area of expertise
Participates in continuing education and completes 48 hours annually of staff
development activities in professional/institutional advancement
                                                   PROFESSIONAL GROWTH SCORE                     0            0
Comments:




Employee Comments:



Evaluator Comments:




         Approved 7/03
                                                                                                                                                                            8
Administrative
UAMS MEDICAL CENTER                                                                          CLINICAL PROGRAMS
(Job Title)                                                                                          PERFORMANCE APPRAISAL


                                                                                           SECTION
                                                                               SECTION      TOTAL
                                                                  SECTION        MAX      FROM EACH          VALUE        SECTION
Rate Employee's Overall Performance                                VALUE       POSSIBLE    SECTION           WEIGHT        SCORE
  I. GUEST RELATIONS (25%)                                              125            25          0                  5                0
     SAFETY AND EMERGENCY PREPAREDNESS
 II.                                                                     50             25            0               2                0
     (10%)
     INSTITUTIONAL/PROFESSIONAL STANDARDS
III.                                                                     25             30            0   0.83333333                   0
     (5%)
IV. PROCESS IMPROVEMENT (5%)                                             25             15           0 1.66666667                      0
V. PERFORMS ROLE OF DIRECTOR (50%)                                      250             65           0 3.84615385                      0
VI. PROFESSIONAL GROWTH (5%)                                             25             10           0         2.5                     0
                                                                                                   OVERALL SCORE                       0

                                                                                                   RECOMMENDED
                                                                                                   MERIT INCREASE

Classified Conversion:        500 - 426 =3 exceeds expectations
425-300 =2 Satisfactory 299-100 = 1 Unsatisfactory


COMMENTS:




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

     I acknowledge that this performance appraisal was discussed with me.                                             Administrative

     Signature does not necessarily mean agreement.

								
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