- Email: [email protected]
Employee Evaluations
A O R N JOURNAL
DECEMBER 1986, VOL. 44, NO 6
Employee Evaluations SHIFTING THE EMPHASIS
Charles R. McConnell
U
ntil recently, evaluations of employee performances were rarely done. Employee evaluations, which originated mainly in the manufacturing industry, entered American working life without a clear, consistent purpose. Some managers pursued evaluations as a means of identifying and eventually dismissing their supposedly troublesome or less productive employees. Even organizations that did not overtly misuse evaluations tended to regard them as “report cards,” graded reports representing an employee’s status. As a result, many employees quickly learned to distrust evaluations. Through such evaluations, employees were criticized, and often that criticism was used to deny pay increases. Occasionally an evaluation contributed to loss of employment. Employees believed (often a valid belief) that an evaluation, as part of a permanent record, could follow them for years through employment references. In short, evaluations were, and to many still are, a negative process. Health care organizations that implemented evaluation programs originallydid so on their own; as recently as the 1970s there were no outside forces able to tell managers that, “You will have a system of employee performance evaluations.” Today national accreditation organizations, such as the Joint Commission on Accreditation of Hospitals, and the regulatory bodies of many states require employee evaluations at regular intervals. Making evaluations a requirement did absolutely nothing to make managers more comfortable with the process or to make employees less resentful and distrustful. As a result, there are
problems making evaluations meaningful for the employee and manager. Those problems will persist if the evaluation focuses on the past and fails to provide for the future, the evaluators are forced to work with a system that is weak in both of its major dimensions-criteria and ratings, the system lacks any of the elements of an effective evaluation system, and employees-especially educated and responsible health care professionals-are not encouraged to take an active part in the process.
CharlesR. McConnell MBA, k the vicepresident f o r employee affairs at Genesee Hospital, Rochester, NY He received his bachelor of science degree in industrial engineering from the University of Buffalo, New York, and his master of business adminktration degree in management from the State University of New York at Buffalo. 993
DECEMBER 1986, VOL. 44, NO 6
AORN JOURNAL
The label evaluation carries a negative connotation for many people-a to formally deliver criticism. A Forward View
T
o many managers and employees, an evaluation is simply a status report, the working adult’s equivalent of a report card. It points out both areas where one is doing well and not doing so well. As a report card, the evaluation focuses on the employee’s past performance ending with the evaluation itself. It is a snapshot, a static picture of the employee’s performance at a particular point in time. The only useful purpose for such an evaluation, and it is a marginal usefulness at best, is as a baseline for the next annual evaluation. Using an evaluation as a baseline reference is precisely what occurs when the manager pulls the employee’s evaluation out of the file only when it is time to write the next evaluation. There is no easy way to evaluate an employee’s performance without looking into the recent past. However, it is how that past is used that determines whether the evaluation system looks forward or backward. If the employee gets a message that, “You didn’t do very well and that’s why you’re not getting a raise or promotion this year,” then the view is clearly backward. If the system is properly oriented to a forward view, the employee should receive a message like, “What’s past is past, and all it counts for is to mark the starting point of an improved future.’’ The label evaluation carries a negative connotation for many people-a means to formally deliver criticism. Because evaluations are often viewed that way, it might be helpful to discuss the basics and consider the objectives of an evaluation.
means
provide the employee with the means to pursue advancement (if desired). In addition, the second primary objective may provide the organization with capable people interested in advancement. In other words, the evaluation process should spotlight those employees who are willing and able to assume greater responsibility. The first primary objective of an evaluation requires qualification. Improving an employee’s performance is, obviously, an objective of an evaluation; however, maintaining their performance is not as likely to be accepted as a legitimate objective of an evaluation, although it is just that. There are always employees in the work force who have no desire to advance but who are doing perfectly acceptable work. Consider the nursing aide, for example, who has done acceptable work at the same job for 20 years; however, the person is limited by his or her education, ability, and aspirations from ever doing much more. An evaluation is a formal means of letting that person know that his or her work is appreciated. As a positive incentive, it can encourage the nursing aide to maintain that acceptable performance. Thus, an evaluation can be just as important to maintaining an employee’s performance as it is to improving performance. When all of the evaluation objectives are considered, the net effect should be to provide each employee with answers to the following questions: (1) In the view of my manager, how am I doing in my job? (2) Where can I reasonably expect to go from here? The manager must approach employee evaluations with those questions in mind.
Evaluation Dimensions Evaluation Objectives
A
n evaluation should have two primary objectives:(1) to improve or maintain the employee’s performance level, and (2) to
994
E
very performance evaluation system that has ever been used can be described in terms of two dimensions: vertical (or criteria), and horizontal (or rating). The criteria
DECEMBER 1986, VOL. 44, NO 6
AORN JOURNAL
With the vertical dimension, there are problems because the evaluator has to render subjective judgments on most criteria. dimension is described as vertical because, traditionally, evaluation criteria are listed in a vertical cotumn on the form. Ratings are described as horizontal because they are entered under headings spread horizontally across the top of the form. Twenty years ago, essentially all evaluation systems were lacking in both dimensions. In recent years, the vertical (criteria) dimension has been improved and its original problems largely eliminated. But there are still problems with the horizontal (rating) dimension. With the vertical dimension, there were problems because the evaluator had to render subjective judgments on most criteria. Many of those judgments were based on an employee’s personality. A “standard” employee evaluation form used in the 1960s listed the following criteria: quality of work, 0: quantity of work, effectiveness, job knowledge, adaptability, initiative, dependability, attitude, cooperation, interpersonal relations, attendance, and appearance. Problems with using such criteria are, for the most part, responsible for the poor reputation of evaluation systems. Few can be measured in an absolute sense; attendance can be counted, and, for some, there are aspects of quantity and quality that can be measured. Most of the criteria, however, require judgment calls by the manager-judgments that cannot be defended in any absolute sense. Several criteria, notably attitude, adaptability, and cooperation, require the evaluator to judge the employee’s personality.
Problems with evaluation criteria were solved by a simple shift in focus from personality to performance, that is, basing the ratings on what the employee does rather than on what the employee appears to be. Using criteria taken directly from an employee’s job description for an evaluation is one way to conquer the worst of the vertical dimension problems. Most of the weaknesses with modern evaluation systems are encountered with the rating (horizontal) dimension. Consider the following ratings used in a particular system: unsatisfactory, below standard, standard, above standard, significantly above standard, and exceptional. Those ratings represent the rank ordering of six possible judgment calk. But who can guarantee that all evaluators will apply them in the same way? Who will define the difference between “significantly above standard” and “exceptional?” And who will assure that one manager’s “standard” is the same as another manager’s “standard?“ Although the majority of evaluation systems do not use personality judgments, they have not done away with the predominantly judgmental nature of evaluations. Systems still require the evaluator to assess one’s performance by applying judgment instead of absolute measures because, for the most part, appropriate absolute measures do not exist. Even the systems that claim to be “criteria based” are largely judgmental based on ratings that have few absolute measurements.
An Effective System
T
he ideal evaluation system would include as many performancestandards as possible. Few systems, however, are standards-M.
DECEMBER 1986, VOL. 44, NO 6
Although it is possible to objectively measure three fourths or more of what is done by unskilled and semiskilled employees and set standards for nearly half of the work of most managers and working professionals, it has not been done in most organizations because setting standards is a costly and time-consuming process. Unfortunately, this state of affairs ensures that most systems will not be optimally effective. Rarely will one encounter an effective system. (See “Characteristics of an Effective System.”) Even the more tolerable systems will ordinarily be lacking job standards (third characteristic). A manager who understands the weaknesses of a system, however, may be able to compensate for them. For example, the manager can focus on performance over personality; the manager can explain, educate, and monitor; and the manager can conduct every evaluation interview regardless of what other department managers may do. Also, if the system lacks specific performance standards, the manager can strive to usejudgment consistently and to apply the same subjective criteria equally to all employees. An evaluation can be constructively influenced by active employee participation. Active participation, however, is not for every employee. Participation will depend on the personality, education, and professional background of the individual employee. Although most employees prefer to have a voice in how they do their jobs, a few prefer to be told what to do. The majority of health care professionals, however, prefer to participate. There are three avenues available for employee participation: self-evaluation, peer evaluation, and joint target setting.
Self-Evahation
A
self-evaluation is best approached as an optional feature. Some employees will feel threatened or uncomfortable with the process. They may agonize over questions such as: If I overrate myself compared to my manager’s rating, will it be held against me? If I underrate myself will I be thought of as lacking confidence or as being deficient in some other way? Some
AORN JOURNAL
Characteristicsof an Effective System An effective evaluation system should: 1. completely serve the objectives of an evaluation 2. focus exclusively on performance, not on personality 3. be based on appropriate job-related criteria 4. include complete explanations of all ratings used 5. be based only on criteria that are fully understood by employees and evaluators 6. be capable of being used as a working tool in the ongoing manageremployee relationship between formal evaluations 7. include an evaluation interview, even if there are no apparent problems to discuss 8. provide for a self-contained record, one that can be completely understood without reference to separate keys, legends, or other material 9. provide for a system administration that will meet deadlines and allow time for all the necessary steps 10. provide education for all managers about the system’s use may try to second-guess the manager, and thus detract rather than add to the self-evaluation. Although the overall evaluation process should not depend on it, a properly approached selfevaluation can significantly enhance the evaluation. Certainly some people will grossly overrate themselves, but experience has shown that the majority of employees tend to rate themselves slightly lower than their managers rated them. A self-evaluation may be added to almost every existing evaluation system. Once an employee has willingly agreed to do a self-evaluation, the manager must provide the employee with the forms and criteria-the same information the manager will use-and a few days to complete it. The manager must complete the employee’s
AORN JOURNAL
DECEMBER 1986, VOL.44, NO 6
If the peer evaluation is not willingly agreed to with a positive attitude by all persons involved, the results can be more harmful than beneficial.
evaluation before seeing the employee’s selfevaluation. That avoids the possibility or the perception of bias, unconscious or otherwise. Early in the evaluation interview, the manager and the employee should compare evaluations. If the two evaluations are far apart on any criteria, then they have uncovered specific aspects of the employee’s performance that they need to focus on. That focus, along with the employee’s increased level of participation, constitutes the primary advantage of a self-evaluation. As valuable as the self-evaluation may seem to a manager, it must be optional. If the employee is threatened by the proms, the resulting problems and resentment will negate any potential benefits.
Peer Evaluation
I
n the peer evaluation process, the individual employee is critiqued by a small group of coworkers. This group, which need consist of only three or four peers, uses the same evaluation mechanism and criteria as the manager uses to evaluate the employee. The manager should rate the employee independently of the peer group and bring the two evaluations together for the first time at the employee’s evaluation interview. A peer evaluation is mostly used for technical and professional employees. Like the selfevaluation, it should be optional. Some employees find a peer evaluation even more threatening than a self-evaluation. If the peer evaluation is not willingly agreed to with a positive attitude by all persons involved, the results can be more harmful than beneficial. Rarely will an entire group be willing to experiment with peer evaluation. Even in a group of highly skilled professionals, such as an operating room staff or coronary care staff, one might find that less than half of the employeesare comfortable enough with the concept to try it. Each person who is willing to become involved should
participate in two ways-as one who is evaluated by a group, and as one who is part of a group that evaluates others. A peer evaluation should be used in the same manner as a self-evaluation-as a supplement to the normal evaluation process and not as a replacement for the manager’s evaluation. If properly approached, peer evaluationscan provide deeper insights into one’s performance than could be provided by a manager’s evaluation alone.
Joint Target Setting
T
he process of joint target setting is strongly recommended for professional employees. Used in conjunction with and supplementary to the normal evaluation process, joint target setting draws the manager and the employee closer together in directing the employee’s future growth. The process is briefly described as follows. 1. To begin what will eventually become a cyclic process, the manager and the employee must agree on the structure of the employee’s job. Initially, the employee should be asked to rework his or her job description while the manager does the same independently. Together, the manager and the employee can negotiate an agreement on the employee’s job-all significant duties, their order of importance, and the amount of freedom the employee needs to do the job. 2. After agreeing on the contents of the job, the manager asks the employee to develop improvement targets related to the job description. The only improvement targets the manager should request or suggest-not mandate-are in areas rated as below standards. Except for those, the employee should be free to develop a list of five or six job-related targets for self-improvement. 3. The manager and the employee meet to negotiate an acceptable set of targets. The manager’s primary role in this negotiation is that of counselor or consultant. The manager should
AORN JOURNAL
not brand a specific target as “acceptable” or “unacceptable” but should help the employee identify targets consistent with the objectives of the department. The manager helps the employee determine targets that are realistic, attainable, and include the three elements of a properly developed objective: what is to be accomplished, how much is to be accomplished, and when is it to be completed. For example,a scheduling target might be, “through improved schedule control, reduce the overtime used by Team One (what) by 20% (how much) within the next six months (when).” The employee’s deadlines can be set from two to three months to as much as two years after the meeting. 4. For joint target setting to be effective, the manager and employee need to discuss progress toward targets at reasonable intervals. At these meetings some targets will have been attained, some targets will likely be altered based on current information, and, perhaps, other targets will be added. Such ongoing contacts can help the employee strive toward positive change. At their next regularly scheduled evaluation, both manager and employee usually find that they are more at ease with the process because they have acquired a fuller appreciation of each other’s viewpoint. The joint target setting approach delivers essentially the same primary benefits as the selfevaluation and peer evaluation4 brings the manager and the employee closer together in their views of the employee’s performance.
An Impevect Process
A
s long as individual judgments are used for employee evaluations, it will be an imperfect process. Only the simplest jobs can have a 100% guarantee of hard-number performance standards. Thus, managerial judgment will remain a significant part of a professional employee’s evaluation. Managers and employees both need to participate in the evaluation process. Because of the amount of judgment involved in evaluations, the employees and managers must: recognize the imperfect nature of the
DECEMBER 1986, VOL. 44, NO 6
evaluation process and accept judgments, recognize the weaknesses in most criteria (horizontal) scales and work toward developing a few specific job standards, use participative approaches whenever possible, and work toward the day when the formal evaluation will be a mere formalitybecause both the employee and the manager will know where they stand with each other.
Drug Abusers Risk Pneumothorax The use of intravenous drugs has led addicts to administer injections into the neck veins, and thus increase the prevalence of pneumothorax, according to a study reported in the July issue of The American Surgeon. The addict uses the subclavian or internal jugular vein in the neck to obtain self-gratification after superficial veins have been obliterated, according to the researchers. The base of the neck is crowded anatomically, therefore, neck injections can result in neck abscess, carotid or subclavian mycotic aneurysm, or pneumothorax. The groin is another popular site for venous access. A study of 525 patients’ hospital records and chest radiographs was conducted at Detroit Receiving Hospital between Jan 1, 1982 and Dec 3 1, 1984. Over the three-year period, the study showed that 113 cases of pneumothorax were diagnosed in 84 patients who abused drugs. Eleven patients showed multiple admissionsfour patients were admitted twice, five patients three times, and one patient seven times. Patients required an average of 6.6 days of hospitalization. Antibiotics were unnecessary except to treat concomitant infectious complications. The prevalence of pneumothorax following neck injections appears to be escalating yearly, according to the study. In 1982,25 admissions were reported, 28 in 1983, and 51 in 1984.
DECEMBER 1986, VOL. 44, NO 6
Employee Evaluations SHIFTING THE EMPHASIS
Charles R. McConnell
U
ntil recently, evaluations of employee performances were rarely done. Employee evaluations, which originated mainly in the manufacturing industry, entered American working life without a clear, consistent purpose. Some managers pursued evaluations as a means of identifying and eventually dismissing their supposedly troublesome or less productive employees. Even organizations that did not overtly misuse evaluations tended to regard them as “report cards,” graded reports representing an employee’s status. As a result, many employees quickly learned to distrust evaluations. Through such evaluations, employees were criticized, and often that criticism was used to deny pay increases. Occasionally an evaluation contributed to loss of employment. Employees believed (often a valid belief) that an evaluation, as part of a permanent record, could follow them for years through employment references. In short, evaluations were, and to many still are, a negative process. Health care organizations that implemented evaluation programs originallydid so on their own; as recently as the 1970s there were no outside forces able to tell managers that, “You will have a system of employee performance evaluations.” Today national accreditation organizations, such as the Joint Commission on Accreditation of Hospitals, and the regulatory bodies of many states require employee evaluations at regular intervals. Making evaluations a requirement did absolutely nothing to make managers more comfortable with the process or to make employees less resentful and distrustful. As a result, there are
problems making evaluations meaningful for the employee and manager. Those problems will persist if the evaluation focuses on the past and fails to provide for the future, the evaluators are forced to work with a system that is weak in both of its major dimensions-criteria and ratings, the system lacks any of the elements of an effective evaluation system, and employees-especially educated and responsible health care professionals-are not encouraged to take an active part in the process.
CharlesR. McConnell MBA, k the vicepresident f o r employee affairs at Genesee Hospital, Rochester, NY He received his bachelor of science degree in industrial engineering from the University of Buffalo, New York, and his master of business adminktration degree in management from the State University of New York at Buffalo. 993
DECEMBER 1986, VOL. 44, NO 6
AORN JOURNAL
The label evaluation carries a negative connotation for many people-a to formally deliver criticism. A Forward View
T
o many managers and employees, an evaluation is simply a status report, the working adult’s equivalent of a report card. It points out both areas where one is doing well and not doing so well. As a report card, the evaluation focuses on the employee’s past performance ending with the evaluation itself. It is a snapshot, a static picture of the employee’s performance at a particular point in time. The only useful purpose for such an evaluation, and it is a marginal usefulness at best, is as a baseline for the next annual evaluation. Using an evaluation as a baseline reference is precisely what occurs when the manager pulls the employee’s evaluation out of the file only when it is time to write the next evaluation. There is no easy way to evaluate an employee’s performance without looking into the recent past. However, it is how that past is used that determines whether the evaluation system looks forward or backward. If the employee gets a message that, “You didn’t do very well and that’s why you’re not getting a raise or promotion this year,” then the view is clearly backward. If the system is properly oriented to a forward view, the employee should receive a message like, “What’s past is past, and all it counts for is to mark the starting point of an improved future.’’ The label evaluation carries a negative connotation for many people-a means to formally deliver criticism. Because evaluations are often viewed that way, it might be helpful to discuss the basics and consider the objectives of an evaluation.
means
provide the employee with the means to pursue advancement (if desired). In addition, the second primary objective may provide the organization with capable people interested in advancement. In other words, the evaluation process should spotlight those employees who are willing and able to assume greater responsibility. The first primary objective of an evaluation requires qualification. Improving an employee’s performance is, obviously, an objective of an evaluation; however, maintaining their performance is not as likely to be accepted as a legitimate objective of an evaluation, although it is just that. There are always employees in the work force who have no desire to advance but who are doing perfectly acceptable work. Consider the nursing aide, for example, who has done acceptable work at the same job for 20 years; however, the person is limited by his or her education, ability, and aspirations from ever doing much more. An evaluation is a formal means of letting that person know that his or her work is appreciated. As a positive incentive, it can encourage the nursing aide to maintain that acceptable performance. Thus, an evaluation can be just as important to maintaining an employee’s performance as it is to improving performance. When all of the evaluation objectives are considered, the net effect should be to provide each employee with answers to the following questions: (1) In the view of my manager, how am I doing in my job? (2) Where can I reasonably expect to go from here? The manager must approach employee evaluations with those questions in mind.
Evaluation Dimensions Evaluation Objectives
A
n evaluation should have two primary objectives:(1) to improve or maintain the employee’s performance level, and (2) to
994
E
very performance evaluation system that has ever been used can be described in terms of two dimensions: vertical (or criteria), and horizontal (or rating). The criteria
DECEMBER 1986, VOL. 44, NO 6
AORN JOURNAL
With the vertical dimension, there are problems because the evaluator has to render subjective judgments on most criteria. dimension is described as vertical because, traditionally, evaluation criteria are listed in a vertical cotumn on the form. Ratings are described as horizontal because they are entered under headings spread horizontally across the top of the form. Twenty years ago, essentially all evaluation systems were lacking in both dimensions. In recent years, the vertical (criteria) dimension has been improved and its original problems largely eliminated. But there are still problems with the horizontal (rating) dimension. With the vertical dimension, there were problems because the evaluator had to render subjective judgments on most criteria. Many of those judgments were based on an employee’s personality. A “standard” employee evaluation form used in the 1960s listed the following criteria: quality of work, 0: quantity of work, effectiveness, job knowledge, adaptability, initiative, dependability, attitude, cooperation, interpersonal relations, attendance, and appearance. Problems with using such criteria are, for the most part, responsible for the poor reputation of evaluation systems. Few can be measured in an absolute sense; attendance can be counted, and, for some, there are aspects of quantity and quality that can be measured. Most of the criteria, however, require judgment calls by the manager-judgments that cannot be defended in any absolute sense. Several criteria, notably attitude, adaptability, and cooperation, require the evaluator to judge the employee’s personality.
Problems with evaluation criteria were solved by a simple shift in focus from personality to performance, that is, basing the ratings on what the employee does rather than on what the employee appears to be. Using criteria taken directly from an employee’s job description for an evaluation is one way to conquer the worst of the vertical dimension problems. Most of the weaknesses with modern evaluation systems are encountered with the rating (horizontal) dimension. Consider the following ratings used in a particular system: unsatisfactory, below standard, standard, above standard, significantly above standard, and exceptional. Those ratings represent the rank ordering of six possible judgment calk. But who can guarantee that all evaluators will apply them in the same way? Who will define the difference between “significantly above standard” and “exceptional?” And who will assure that one manager’s “standard” is the same as another manager’s “standard?“ Although the majority of evaluation systems do not use personality judgments, they have not done away with the predominantly judgmental nature of evaluations. Systems still require the evaluator to assess one’s performance by applying judgment instead of absolute measures because, for the most part, appropriate absolute measures do not exist. Even the systems that claim to be “criteria based” are largely judgmental based on ratings that have few absolute measurements.
An Effective System
T
he ideal evaluation system would include as many performancestandards as possible. Few systems, however, are standards-M.
DECEMBER 1986, VOL. 44, NO 6
Although it is possible to objectively measure three fourths or more of what is done by unskilled and semiskilled employees and set standards for nearly half of the work of most managers and working professionals, it has not been done in most organizations because setting standards is a costly and time-consuming process. Unfortunately, this state of affairs ensures that most systems will not be optimally effective. Rarely will one encounter an effective system. (See “Characteristics of an Effective System.”) Even the more tolerable systems will ordinarily be lacking job standards (third characteristic). A manager who understands the weaknesses of a system, however, may be able to compensate for them. For example, the manager can focus on performance over personality; the manager can explain, educate, and monitor; and the manager can conduct every evaluation interview regardless of what other department managers may do. Also, if the system lacks specific performance standards, the manager can strive to usejudgment consistently and to apply the same subjective criteria equally to all employees. An evaluation can be constructively influenced by active employee participation. Active participation, however, is not for every employee. Participation will depend on the personality, education, and professional background of the individual employee. Although most employees prefer to have a voice in how they do their jobs, a few prefer to be told what to do. The majority of health care professionals, however, prefer to participate. There are three avenues available for employee participation: self-evaluation, peer evaluation, and joint target setting.
Self-Evahation
A
self-evaluation is best approached as an optional feature. Some employees will feel threatened or uncomfortable with the process. They may agonize over questions such as: If I overrate myself compared to my manager’s rating, will it be held against me? If I underrate myself will I be thought of as lacking confidence or as being deficient in some other way? Some
AORN JOURNAL
Characteristicsof an Effective System An effective evaluation system should: 1. completely serve the objectives of an evaluation 2. focus exclusively on performance, not on personality 3. be based on appropriate job-related criteria 4. include complete explanations of all ratings used 5. be based only on criteria that are fully understood by employees and evaluators 6. be capable of being used as a working tool in the ongoing manageremployee relationship between formal evaluations 7. include an evaluation interview, even if there are no apparent problems to discuss 8. provide for a self-contained record, one that can be completely understood without reference to separate keys, legends, or other material 9. provide for a system administration that will meet deadlines and allow time for all the necessary steps 10. provide education for all managers about the system’s use may try to second-guess the manager, and thus detract rather than add to the self-evaluation. Although the overall evaluation process should not depend on it, a properly approached selfevaluation can significantly enhance the evaluation. Certainly some people will grossly overrate themselves, but experience has shown that the majority of employees tend to rate themselves slightly lower than their managers rated them. A self-evaluation may be added to almost every existing evaluation system. Once an employee has willingly agreed to do a self-evaluation, the manager must provide the employee with the forms and criteria-the same information the manager will use-and a few days to complete it. The manager must complete the employee’s
AORN JOURNAL
DECEMBER 1986, VOL.44, NO 6
If the peer evaluation is not willingly agreed to with a positive attitude by all persons involved, the results can be more harmful than beneficial.
evaluation before seeing the employee’s selfevaluation. That avoids the possibility or the perception of bias, unconscious or otherwise. Early in the evaluation interview, the manager and the employee should compare evaluations. If the two evaluations are far apart on any criteria, then they have uncovered specific aspects of the employee’s performance that they need to focus on. That focus, along with the employee’s increased level of participation, constitutes the primary advantage of a self-evaluation. As valuable as the self-evaluation may seem to a manager, it must be optional. If the employee is threatened by the proms, the resulting problems and resentment will negate any potential benefits.
Peer Evaluation
I
n the peer evaluation process, the individual employee is critiqued by a small group of coworkers. This group, which need consist of only three or four peers, uses the same evaluation mechanism and criteria as the manager uses to evaluate the employee. The manager should rate the employee independently of the peer group and bring the two evaluations together for the first time at the employee’s evaluation interview. A peer evaluation is mostly used for technical and professional employees. Like the selfevaluation, it should be optional. Some employees find a peer evaluation even more threatening than a self-evaluation. If the peer evaluation is not willingly agreed to with a positive attitude by all persons involved, the results can be more harmful than beneficial. Rarely will an entire group be willing to experiment with peer evaluation. Even in a group of highly skilled professionals, such as an operating room staff or coronary care staff, one might find that less than half of the employeesare comfortable enough with the concept to try it. Each person who is willing to become involved should
participate in two ways-as one who is evaluated by a group, and as one who is part of a group that evaluates others. A peer evaluation should be used in the same manner as a self-evaluation-as a supplement to the normal evaluation process and not as a replacement for the manager’s evaluation. If properly approached, peer evaluationscan provide deeper insights into one’s performance than could be provided by a manager’s evaluation alone.
Joint Target Setting
T
he process of joint target setting is strongly recommended for professional employees. Used in conjunction with and supplementary to the normal evaluation process, joint target setting draws the manager and the employee closer together in directing the employee’s future growth. The process is briefly described as follows. 1. To begin what will eventually become a cyclic process, the manager and the employee must agree on the structure of the employee’s job. Initially, the employee should be asked to rework his or her job description while the manager does the same independently. Together, the manager and the employee can negotiate an agreement on the employee’s job-all significant duties, their order of importance, and the amount of freedom the employee needs to do the job. 2. After agreeing on the contents of the job, the manager asks the employee to develop improvement targets related to the job description. The only improvement targets the manager should request or suggest-not mandate-are in areas rated as below standards. Except for those, the employee should be free to develop a list of five or six job-related targets for self-improvement. 3. The manager and the employee meet to negotiate an acceptable set of targets. The manager’s primary role in this negotiation is that of counselor or consultant. The manager should
AORN JOURNAL
not brand a specific target as “acceptable” or “unacceptable” but should help the employee identify targets consistent with the objectives of the department. The manager helps the employee determine targets that are realistic, attainable, and include the three elements of a properly developed objective: what is to be accomplished, how much is to be accomplished, and when is it to be completed. For example,a scheduling target might be, “through improved schedule control, reduce the overtime used by Team One (what) by 20% (how much) within the next six months (when).” The employee’s deadlines can be set from two to three months to as much as two years after the meeting. 4. For joint target setting to be effective, the manager and employee need to discuss progress toward targets at reasonable intervals. At these meetings some targets will have been attained, some targets will likely be altered based on current information, and, perhaps, other targets will be added. Such ongoing contacts can help the employee strive toward positive change. At their next regularly scheduled evaluation, both manager and employee usually find that they are more at ease with the process because they have acquired a fuller appreciation of each other’s viewpoint. The joint target setting approach delivers essentially the same primary benefits as the selfevaluation and peer evaluation4 brings the manager and the employee closer together in their views of the employee’s performance.
An Impevect Process
A
s long as individual judgments are used for employee evaluations, it will be an imperfect process. Only the simplest jobs can have a 100% guarantee of hard-number performance standards. Thus, managerial judgment will remain a significant part of a professional employee’s evaluation. Managers and employees both need to participate in the evaluation process. Because of the amount of judgment involved in evaluations, the employees and managers must: recognize the imperfect nature of the
DECEMBER 1986, VOL. 44, NO 6
evaluation process and accept judgments, recognize the weaknesses in most criteria (horizontal) scales and work toward developing a few specific job standards, use participative approaches whenever possible, and work toward the day when the formal evaluation will be a mere formalitybecause both the employee and the manager will know where they stand with each other.
Drug Abusers Risk Pneumothorax The use of intravenous drugs has led addicts to administer injections into the neck veins, and thus increase the prevalence of pneumothorax, according to a study reported in the July issue of The American Surgeon. The addict uses the subclavian or internal jugular vein in the neck to obtain self-gratification after superficial veins have been obliterated, according to the researchers. The base of the neck is crowded anatomically, therefore, neck injections can result in neck abscess, carotid or subclavian mycotic aneurysm, or pneumothorax. The groin is another popular site for venous access. A study of 525 patients’ hospital records and chest radiographs was conducted at Detroit Receiving Hospital between Jan 1, 1982 and Dec 3 1, 1984. Over the three-year period, the study showed that 113 cases of pneumothorax were diagnosed in 84 patients who abused drugs. Eleven patients showed multiple admissionsfour patients were admitted twice, five patients three times, and one patient seven times. Patients required an average of 6.6 days of hospitalization. Antibiotics were unnecessary except to treat concomitant infectious complications. The prevalence of pneumothorax following neck injections appears to be escalating yearly, according to the study. In 1982,25 admissions were reported, 28 in 1983, and 51 in 1984.