- Email: [email protected]
Perioperative Employee Annual Evaluations: A 30-Second Process
Perioperative Employee Annual Evaluations: A 30-Second Process JOHN OLMSTEAD, MBA, RN, CNOR, FACHE; DEBORAH FALCONE, RN; JACY LOPEZ, RN; LORRAINE SHARPE, RN; JODY MICHNA, RN
ABSTRACT In response to complaints about the annual evaluation tool used at The Community Hospital in Munster, Indiana, the surgical services management team created a tool to rate the perioperative RNs on skills pertinent to the surgical services department. The hospital-wide evaluation tool uses vague criteria, which are regularly challenged by employees who disagree with their manager’s evaluation. The new Surgical Services Employee Evaluation takes a manager approximately 30 seconds to complete and can be added to the generic hospital evaluation form to make the employee evaluation more accurate and meaningful. The tool evaluates three major categories: teamwork, patient care, and job preparation. Use of this additional tool has greatly reduced postevaluation employee complaints, and the tool is now being used in other departments, with slight department-specific variations. Employees now express less frustration with annual evaluations, and managers report a high degree of satisfaction with the tool because it helps them in the difficult task of employee evaluation and counseling. AORN J 96 (December 2012) 627-633. Ó AORN, Inc, 2012. http://dx.doi.org/10.1016/j.aorn.2012.09.023 Key words: performance evaluations, nursing evaluations, assessing competency.
T
he Community Hospital of Munster, Indiana, is a 400-bed tertiary care medical center located approximately 25 miles from downtown Chicago, Illinois. Surgical services department staff members perform 10,000 surgical and 5,000 gastrointestinal procedures annually, and the department has a staff of approximately 160 full-time equivalent employees. Formerly, annual evaluation of the employees in perioperative services presented a problem. Managers used the hospital’s generic evaluation form, which is based on hospital mission statement goals and includes poorly defined expectations for employees to meet, such as dignity, quality, and compassion (Figure 1).
Admirable as these expectations are, their vague and nonmeasurable nature guaranteed regular challenges from employees. Perioperative RNs frequently complained that the rating categories in the evaluation tool were inadequate to address nursing performance. Nurses also felt that the form focused on negative performances. For example, the evaluation measured missed shifts because of absences, but it did not credit employees who were routinely flexible in picking up extra shifts and rearranging their schedules to accommodate the varying daily department workload. The evaluation forced the manager to subjectively grade employees as performing below
http://dx.doi.org/10.1016/j.aorn.2012.09.023
Ó AORN, Inc, 2012
December 2012
Vol 96 No 6
AORN Journal j 627
OLMSTEAD ET AL
December 2012 Vol 96 No 6
Figure 1. Example of the hospital annual evaluation rating categories.
expectations, meeting expectations, performing above expectations, or exceeding expectations. The tool provided no definitive or objective feedback to employees on the value they delivered to the organization or their performance. These subjective ratings were the main source of conflict. In the absence of hospital-wide defined criteria for each category, employees often faced vastly different evaluations and corresponding pay rates, depending on which manager performed their evaluation. The surgical services management team had used the hospital template for annual employee evaluations for years and regularly had to deal with the resulting employee frustration, questions, and complaints. In response to these complaints, the team set out to create an improved evaluation tool that more accurately assesses the value an employee brings to the organization. In an effort to make employee evaluations more relevant, we wanted to add job-specific functions to the performance evaluation. OUR PROJECT The need for a timely and accurate appraisal of work performance has long been documented in the literature.1-4 In 1978, Atchison2 discussed the idea of a timely and accurate appraisal and suggested 628 j AORN Journal
that employees should be graded specifically on how accurately they perform tasks, spelled out by management, that are relevant to the success of the organization. The surgical services management team approached the performance appraisal overhaul by brainstorming examples of categories that could be added to the evaluation form, such as patient care, charting, and safety. Although more pertinent, these categories lacked defined criteria for actions that met or did not meet expectations. The team members recognized that any new evaluation tool must be able to assess the employee on a number of items not previously mentioned in the current evaluation tool. The team finally agreed on three major categories of surgical services employee service: teamwork, patient care, and job preparation. Teamwork The surgical services management team believes that The Community Hospital succeeds or fails as a team. Lack of teamwork can create myriad avoidable problems (eg, poor customer relations).5 Even the most knowledgeable RN will fail if he or she cannot function within the team structure, and poor relationships inside the team directly lead to an unsafe patient care environment.6 In addition, an
PERIOPERATIVE EMPLOYEE EVALUATIONS employee interfering with a manager’s duties (eg, by behavior that forces the manager to deal with an employee who is acting out) sabotages the success of the department. Positive team relations proactively avoid pitfalls and can actually boost hospital finances,5 and an employee with a positive relationship with his or her manager facilitates the success of the institution. Perioperative nurses also work with members of other departments that facilitate patient care. As a result, the new evaluation tool had to be able to assess a nurse’s relationships with physicians, coworkers, department leaders, and personnel in other departments. Patient Care Often, patient care is defined in evaluations by mechanical tasks such as passing medications, obtaining vital signs, and interpreting medical data such as electrocardiogram rhythms and laboratory values. The surgical services management team identified that these tasks did little to evaluate the perioperative employee. The true value of employees is in their ability to successfully complete assigned tasks, regardless of the specifics of that task. Thus, the team included the following items in the new evaluation tool: n
Autonomy, also called initiative or self-direction, is defined as the amount of time and energy that a leader needs to guide an employee in performing assigned tasks.
n
Self-sufficiency is defined as the amount of assistance that the employee needed from leaders or coworkers to perform daily assignments.
n
Customer service and patient safety are included because of the crucial importance that these facets play in providing safe care.
n
Charting and billing are included because there were huge variances in staff member accuracy and specificity in these areas. Extremely poor charting and billing skills were being addressed with employees; however, excellence in charting and billing was rarely celebrated.
www.aornjournal.org
Job Preparation Organizations rely on their employees’ use of acquired skills to achieve defined goals; however, employees often have different degrees of success in applying their skills. For example, some employees rarely miss or are rarely late for scheduled shifts, whereas some often miss or are late for scheduled shifts, which affects a department’s performance and the care delivered. Another example is the completion of mandatory education assignments, such as basic skill certification; some employees track their own required completion dates and recertify as necessary, others need continual prompting from managers to meet these competencies. As a result, the management team added compliance with the following expectations to the new evaluation tool: n
Procedure preparation: the nurse is able to routinely anticipate assigned procedure needs, thus providing timely, quality care. n Attendance: per hospital attendance policy, the nurse is on time for all assigned shifts. n Mandatory certifications: the nurse completes all required certifications in a timely manner and requires no more than one reminder. n Cross-training: the nurse is cross-trained to the department’s responsibilities and able to handle the majority of the department’s variances in workload. In a bonus section, the new evaluation tool identifies and credits employees who pursue nonmandatory activities that benefit both the hospital and patients alike (eg, specialty certification, participation in professional associations). OUTCOMES After several revisions, the management team arrived at the current version of the Surgical Services Employee Evaluation (Table 1). A demonstration of this evaluation tool can be viewed at http://www.you tube.com/watch?v¼5HL1f6QO2Rw. Managers use the hospital’s generic annual evaluation tool throughout our system, and our new AORN Journal j 629
OLMSTEAD ET AL
December 2012 Vol 96 No 6
TABLE 1. Surgical Services Employee Evaluation Far below Teamwork Relationship with physicians
Does not meet
Meets
Above
Exceeds
Frequently receives Occasionally reExhibits friendly complaints from ceives complaints attitude toward physicians from physicians physicians
Often receives Frequently requescompliments from ted by physician physicians
Relationship with coworkers
Frequently receives Occasionally reExhibits friendly complaints from ceives complaints attitude toward coworkers from coworkers coworkers
Often receives compliments from charge nurse/ coworkers
Relationship with department leadership
Derides/interferes with department leadership
Volunteers to help Innovates improvein hospital-wide ments to help committees, extra leadership better projects achieve the department’s mission
Relationship with departments within the hospital
Frequently receives Occasionally reExhibits profesOften receives complaints from ceives complaints sional, positive, compliments other department from other depar- and helpful befrom other management/staff tment managehavior toward departments ment/staff other departments
Performs afterhours expectations of role
Does not meet basic holiday/ on-call expectations
Patient care Autonomy
Frequently critical of department policies/ procedures/ leadership
Exhibits positive attitude toward department leadership
Inflexible in trading Meets department call/work dates on-call/holiday to accommodate expectations coworker/department needs
N/A
N/A
Very flexible in Accepts a much trading call/work higher on-call/ dates to accomover time/holiday modate coworker/ load than other department needs employees
Often needs rediNeeds occasional rection/prompting prompting from from leadership leadership
Performs work as directed
Actively engages in work without direction
Brings solutions to leadership on a regular basis
Self- sufficiency
Frequently needs Needs occasional assistance perassistance in forming tasks routine tasks learned in general orientation
Performs work as Only needs assisdirected, seeking tance in rare help as needed instances
Serves as role model/instructor for other employees
Accuracy in process performance
Managerial intervention needed to correct performance
Completes charting/billing appropriately
630 j AORN Journal
Routinely misses key charting/ billing elements
Participates in Innovates improvehospital commitments to better tees to improve achieve the patient care department’s mission
PERIOPERATIVE EMPLOYEE EVALUATIONS
www.aornjournal.org
TABLE 1. (continued ) Surgical Services Employee Evaluation Far below
Does not meet
Meets
Customer service
Does not exhibit Sometimes fails to expected patient exhibit expected satisfaction patient satisfacbehaviors tion behaviors
Patient safety
Has caused direct Does not exhibit Exhibits expected harm to a patient expected patient patient safety due to failure to safety behaviors behaviors follow patient safety policies
Job preparation Procedure preRoutinely needs paration (pertinent to be counseled only to procedure about poor departments) procedure preparation
Exhibits expected patient satisfaction behaviors
Above
Exceeds
Often receives Serves as role compliments from model/instructor patients/family for other members employees N/A
Serves as role model/instructor for other employees
Needs occasional prompting from leadership in procedure preparation performance
Prepares adequately for procedures so they can be performed without delay
N/A
Routinely reviews future schedule for potential equipment/supply needs
Attendance
Written disciplinary action initiated
Verbal warning issued
Meets expectations
N/A
N/A
Mandatory certifications (eg, CPR, ACLS)
Failed to meet expectations
Needs prompting Meets expectations from leadership to meet expectations
N/A
N/A
Areas trained to cover
Bonus section Specialty certification Participation in professional association
N/A
N/A
General duties
General duties þ one additional duty (ie, charge nurse, specialty area)
N/A
N/A
Not required
Specialty certification
N/A
N/A
Not required
Member of profes- Participates in sional association professional association by regularly attending meetings and introducing new processes/ideas
Multiple additional areas/duties
N/A
N/A ¼ not applicable.
AORN Journal j 631
OLMSTEAD ET AL
December 2012 Vol 96 No 6
evaluation tool has not completely replaced it; however, the tool is used in the following way in the surgical services department. With practice, the manager can complete the evaluation in approximately 30 seconds, noting an employee’s performance highs and lows. The manager then n
transfers highlights from the 30-second evaluation to the generic annual evaluation tool,
n
reviews these highlights with staff RNs during their annual evaluations, and
n
uses the evaluation to coach staff RNs to further develop their careers.
The management team has refitted the tool for use in several other departments, including the intensive care unit, postanesthesia care unit, emergency department, gastrointestinal laboratory, and radiology department. Successes reported by staff members and managers from these areas include the following: n
Managers can now provide better-defined evaluations, and the specific behaviors outlined in the 30-second evaluation help to emphasize employee successes and identify goals for performance improvement.
n
Managers view the new tool as providing more uniform and defendable evaluations. Employees rated below or above average are given examples of specific behaviors that support the rating. In addition, the criteria for how the different ratings are defined are clear to employees as are the manager’s expectations.
n
Complaints from staff members concerning unfair evaluations have stopped. Managers are able to be consistent in their ratings and the language they use when providing performance reviews.
n
Employees who “go the extra mile” while performing their work are rewarded; this has been identified as the biggest strength of the 30-second evaluation because employees who excel are no longer forgotten.
Occasionally an employee will fail to meet the behavioral performance expectations spelled out 632 j AORN Journal
in the hospital’s employee handbook. When such instances occur, management team members are alerted by the new evaluation process and can provide the employee with education about how to meet expectations. Use of the Surgical Services Employee Evaluation facilitates this task by allowing the manager to n
rate the employee’s performance and clearly identify weaknesses that must be improved, n provide employees with a documented evaluation that helps to educate them about their current behavior, and n create a list of expectations to which the employee must comply to meet hospital-defined behavioral standards. CONCLUSION In addition to saving managers time in deliberating over vague measurements as they apply to different employees, the Surgical Services Employee Evaluation has greatly reduced postevaluation employee complaints. Since its creation, the tool has been used with slight department-specific variations in other departments. All managers who have used it report a high degree of satisfaction with the assistance that the tool provides with the difficult task of employee evaluation and counseling. Employees receive a less subjective evaluation of their performance and have definable goals that can be achieved to improve their performance. Outstanding employees no longer feel that their valuable contributions are ignored, which adds to nurse satisfaction. References 1. Longnecker CO. Key managerial competencies for valueadded appraisals. J Comp Benefits. 2011;27(5):11-18. 2. Atchison TJ. Installing Pay for Performance, Management Today: Managing Work in Organizations. Boston, MA: Houghton Mifflin Harcourt; 1978. 3. Smith K. Reinvigorating performance evaluation: first steps in a local health department. Publ Health Nurs. 2010; 27(5):425-432. 4. Froydis VA. Employee’s perceptions of justice in performance appraisals. Nurs Manage-UK. 2010;17(2): 30-34. 5. Studer Q. Hardwiring Excellence: Purpose, Worthwhile Work, Making a Difference. Gulf Breeze, FL: Fire Starter Publishing; 2003.
PERIOPERATIVE EMPLOYEE EVALUATIONS 6. Kalisch BJ. Risk management. The impact of RN-UAP relationships on quality and safety. Nurs Manage. 2011; 42(9):16-22.
John Olmstead, MBA, RN, CNOR, FACHE, is the director of surgical services and the emergency department at The Community Hospital, Munster, IN. Mr Olmstead has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article. Deborah Falcone, RN, is the manager of the surgery department at The Community Hospital, Munster, IN. Ms Falcone has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article. Jacy Lopez, RN, is the assistant manager of the surgery department at The Community
www.aornjournal.org
Hospital, Munster, IN. Ms Lopez has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article. Lorraine Sharpe, RN, is the manager of the same day surgery department and gastrointestinal laboratory at The Community Hospital, Munster, IN. Ms Sharpe has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article. Jody Michna, RN, is the manager of the postanesthesia care unit at The Community Hospital, Munster, IN. Ms Michna has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article.
AORN Journal j 633
ABSTRACT In response to complaints about the annual evaluation tool used at The Community Hospital in Munster, Indiana, the surgical services management team created a tool to rate the perioperative RNs on skills pertinent to the surgical services department. The hospital-wide evaluation tool uses vague criteria, which are regularly challenged by employees who disagree with their manager’s evaluation. The new Surgical Services Employee Evaluation takes a manager approximately 30 seconds to complete and can be added to the generic hospital evaluation form to make the employee evaluation more accurate and meaningful. The tool evaluates three major categories: teamwork, patient care, and job preparation. Use of this additional tool has greatly reduced postevaluation employee complaints, and the tool is now being used in other departments, with slight department-specific variations. Employees now express less frustration with annual evaluations, and managers report a high degree of satisfaction with the tool because it helps them in the difficult task of employee evaluation and counseling. AORN J 96 (December 2012) 627-633. Ó AORN, Inc, 2012. http://dx.doi.org/10.1016/j.aorn.2012.09.023 Key words: performance evaluations, nursing evaluations, assessing competency.
T
he Community Hospital of Munster, Indiana, is a 400-bed tertiary care medical center located approximately 25 miles from downtown Chicago, Illinois. Surgical services department staff members perform 10,000 surgical and 5,000 gastrointestinal procedures annually, and the department has a staff of approximately 160 full-time equivalent employees. Formerly, annual evaluation of the employees in perioperative services presented a problem. Managers used the hospital’s generic evaluation form, which is based on hospital mission statement goals and includes poorly defined expectations for employees to meet, such as dignity, quality, and compassion (Figure 1).
Admirable as these expectations are, their vague and nonmeasurable nature guaranteed regular challenges from employees. Perioperative RNs frequently complained that the rating categories in the evaluation tool were inadequate to address nursing performance. Nurses also felt that the form focused on negative performances. For example, the evaluation measured missed shifts because of absences, but it did not credit employees who were routinely flexible in picking up extra shifts and rearranging their schedules to accommodate the varying daily department workload. The evaluation forced the manager to subjectively grade employees as performing below
http://dx.doi.org/10.1016/j.aorn.2012.09.023
Ó AORN, Inc, 2012
December 2012
Vol 96 No 6
AORN Journal j 627
OLMSTEAD ET AL
December 2012 Vol 96 No 6
Figure 1. Example of the hospital annual evaluation rating categories.
expectations, meeting expectations, performing above expectations, or exceeding expectations. The tool provided no definitive or objective feedback to employees on the value they delivered to the organization or their performance. These subjective ratings were the main source of conflict. In the absence of hospital-wide defined criteria for each category, employees often faced vastly different evaluations and corresponding pay rates, depending on which manager performed their evaluation. The surgical services management team had used the hospital template for annual employee evaluations for years and regularly had to deal with the resulting employee frustration, questions, and complaints. In response to these complaints, the team set out to create an improved evaluation tool that more accurately assesses the value an employee brings to the organization. In an effort to make employee evaluations more relevant, we wanted to add job-specific functions to the performance evaluation. OUR PROJECT The need for a timely and accurate appraisal of work performance has long been documented in the literature.1-4 In 1978, Atchison2 discussed the idea of a timely and accurate appraisal and suggested 628 j AORN Journal
that employees should be graded specifically on how accurately they perform tasks, spelled out by management, that are relevant to the success of the organization. The surgical services management team approached the performance appraisal overhaul by brainstorming examples of categories that could be added to the evaluation form, such as patient care, charting, and safety. Although more pertinent, these categories lacked defined criteria for actions that met or did not meet expectations. The team members recognized that any new evaluation tool must be able to assess the employee on a number of items not previously mentioned in the current evaluation tool. The team finally agreed on three major categories of surgical services employee service: teamwork, patient care, and job preparation. Teamwork The surgical services management team believes that The Community Hospital succeeds or fails as a team. Lack of teamwork can create myriad avoidable problems (eg, poor customer relations).5 Even the most knowledgeable RN will fail if he or she cannot function within the team structure, and poor relationships inside the team directly lead to an unsafe patient care environment.6 In addition, an
PERIOPERATIVE EMPLOYEE EVALUATIONS employee interfering with a manager’s duties (eg, by behavior that forces the manager to deal with an employee who is acting out) sabotages the success of the department. Positive team relations proactively avoid pitfalls and can actually boost hospital finances,5 and an employee with a positive relationship with his or her manager facilitates the success of the institution. Perioperative nurses also work with members of other departments that facilitate patient care. As a result, the new evaluation tool had to be able to assess a nurse’s relationships with physicians, coworkers, department leaders, and personnel in other departments. Patient Care Often, patient care is defined in evaluations by mechanical tasks such as passing medications, obtaining vital signs, and interpreting medical data such as electrocardiogram rhythms and laboratory values. The surgical services management team identified that these tasks did little to evaluate the perioperative employee. The true value of employees is in their ability to successfully complete assigned tasks, regardless of the specifics of that task. Thus, the team included the following items in the new evaluation tool: n
Autonomy, also called initiative or self-direction, is defined as the amount of time and energy that a leader needs to guide an employee in performing assigned tasks.
n
Self-sufficiency is defined as the amount of assistance that the employee needed from leaders or coworkers to perform daily assignments.
n
Customer service and patient safety are included because of the crucial importance that these facets play in providing safe care.
n
Charting and billing are included because there were huge variances in staff member accuracy and specificity in these areas. Extremely poor charting and billing skills were being addressed with employees; however, excellence in charting and billing was rarely celebrated.
www.aornjournal.org
Job Preparation Organizations rely on their employees’ use of acquired skills to achieve defined goals; however, employees often have different degrees of success in applying their skills. For example, some employees rarely miss or are rarely late for scheduled shifts, whereas some often miss or are late for scheduled shifts, which affects a department’s performance and the care delivered. Another example is the completion of mandatory education assignments, such as basic skill certification; some employees track their own required completion dates and recertify as necessary, others need continual prompting from managers to meet these competencies. As a result, the management team added compliance with the following expectations to the new evaluation tool: n
Procedure preparation: the nurse is able to routinely anticipate assigned procedure needs, thus providing timely, quality care. n Attendance: per hospital attendance policy, the nurse is on time for all assigned shifts. n Mandatory certifications: the nurse completes all required certifications in a timely manner and requires no more than one reminder. n Cross-training: the nurse is cross-trained to the department’s responsibilities and able to handle the majority of the department’s variances in workload. In a bonus section, the new evaluation tool identifies and credits employees who pursue nonmandatory activities that benefit both the hospital and patients alike (eg, specialty certification, participation in professional associations). OUTCOMES After several revisions, the management team arrived at the current version of the Surgical Services Employee Evaluation (Table 1). A demonstration of this evaluation tool can be viewed at http://www.you tube.com/watch?v¼5HL1f6QO2Rw. Managers use the hospital’s generic annual evaluation tool throughout our system, and our new AORN Journal j 629
OLMSTEAD ET AL
December 2012 Vol 96 No 6
TABLE 1. Surgical Services Employee Evaluation Far below Teamwork Relationship with physicians
Does not meet
Meets
Above
Exceeds
Frequently receives Occasionally reExhibits friendly complaints from ceives complaints attitude toward physicians from physicians physicians
Often receives Frequently requescompliments from ted by physician physicians
Relationship with coworkers
Frequently receives Occasionally reExhibits friendly complaints from ceives complaints attitude toward coworkers from coworkers coworkers
Often receives compliments from charge nurse/ coworkers
Relationship with department leadership
Derides/interferes with department leadership
Volunteers to help Innovates improvein hospital-wide ments to help committees, extra leadership better projects achieve the department’s mission
Relationship with departments within the hospital
Frequently receives Occasionally reExhibits profesOften receives complaints from ceives complaints sional, positive, compliments other department from other depar- and helpful befrom other management/staff tment managehavior toward departments ment/staff other departments
Performs afterhours expectations of role
Does not meet basic holiday/ on-call expectations
Patient care Autonomy
Frequently critical of department policies/ procedures/ leadership
Exhibits positive attitude toward department leadership
Inflexible in trading Meets department call/work dates on-call/holiday to accommodate expectations coworker/department needs
N/A
N/A
Very flexible in Accepts a much trading call/work higher on-call/ dates to accomover time/holiday modate coworker/ load than other department needs employees
Often needs rediNeeds occasional rection/prompting prompting from from leadership leadership
Performs work as directed
Actively engages in work without direction
Brings solutions to leadership on a regular basis
Self- sufficiency
Frequently needs Needs occasional assistance perassistance in forming tasks routine tasks learned in general orientation
Performs work as Only needs assisdirected, seeking tance in rare help as needed instances
Serves as role model/instructor for other employees
Accuracy in process performance
Managerial intervention needed to correct performance
Completes charting/billing appropriately
630 j AORN Journal
Routinely misses key charting/ billing elements
Participates in Innovates improvehospital commitments to better tees to improve achieve the patient care department’s mission
PERIOPERATIVE EMPLOYEE EVALUATIONS
www.aornjournal.org
TABLE 1. (continued ) Surgical Services Employee Evaluation Far below
Does not meet
Meets
Customer service
Does not exhibit Sometimes fails to expected patient exhibit expected satisfaction patient satisfacbehaviors tion behaviors
Patient safety
Has caused direct Does not exhibit Exhibits expected harm to a patient expected patient patient safety due to failure to safety behaviors behaviors follow patient safety policies
Job preparation Procedure preRoutinely needs paration (pertinent to be counseled only to procedure about poor departments) procedure preparation
Exhibits expected patient satisfaction behaviors
Above
Exceeds
Often receives Serves as role compliments from model/instructor patients/family for other members employees N/A
Serves as role model/instructor for other employees
Needs occasional prompting from leadership in procedure preparation performance
Prepares adequately for procedures so they can be performed without delay
N/A
Routinely reviews future schedule for potential equipment/supply needs
Attendance
Written disciplinary action initiated
Verbal warning issued
Meets expectations
N/A
N/A
Mandatory certifications (eg, CPR, ACLS)
Failed to meet expectations
Needs prompting Meets expectations from leadership to meet expectations
N/A
N/A
Areas trained to cover
Bonus section Specialty certification Participation in professional association
N/A
N/A
General duties
General duties þ one additional duty (ie, charge nurse, specialty area)
N/A
N/A
Not required
Specialty certification
N/A
N/A
Not required
Member of profes- Participates in sional association professional association by regularly attending meetings and introducing new processes/ideas
Multiple additional areas/duties
N/A
N/A ¼ not applicable.
AORN Journal j 631
OLMSTEAD ET AL
December 2012 Vol 96 No 6
evaluation tool has not completely replaced it; however, the tool is used in the following way in the surgical services department. With practice, the manager can complete the evaluation in approximately 30 seconds, noting an employee’s performance highs and lows. The manager then n
transfers highlights from the 30-second evaluation to the generic annual evaluation tool,
n
reviews these highlights with staff RNs during their annual evaluations, and
n
uses the evaluation to coach staff RNs to further develop their careers.
The management team has refitted the tool for use in several other departments, including the intensive care unit, postanesthesia care unit, emergency department, gastrointestinal laboratory, and radiology department. Successes reported by staff members and managers from these areas include the following: n
Managers can now provide better-defined evaluations, and the specific behaviors outlined in the 30-second evaluation help to emphasize employee successes and identify goals for performance improvement.
n
Managers view the new tool as providing more uniform and defendable evaluations. Employees rated below or above average are given examples of specific behaviors that support the rating. In addition, the criteria for how the different ratings are defined are clear to employees as are the manager’s expectations.
n
Complaints from staff members concerning unfair evaluations have stopped. Managers are able to be consistent in their ratings and the language they use when providing performance reviews.
n
Employees who “go the extra mile” while performing their work are rewarded; this has been identified as the biggest strength of the 30-second evaluation because employees who excel are no longer forgotten.
Occasionally an employee will fail to meet the behavioral performance expectations spelled out 632 j AORN Journal
in the hospital’s employee handbook. When such instances occur, management team members are alerted by the new evaluation process and can provide the employee with education about how to meet expectations. Use of the Surgical Services Employee Evaluation facilitates this task by allowing the manager to n
rate the employee’s performance and clearly identify weaknesses that must be improved, n provide employees with a documented evaluation that helps to educate them about their current behavior, and n create a list of expectations to which the employee must comply to meet hospital-defined behavioral standards. CONCLUSION In addition to saving managers time in deliberating over vague measurements as they apply to different employees, the Surgical Services Employee Evaluation has greatly reduced postevaluation employee complaints. Since its creation, the tool has been used with slight department-specific variations in other departments. All managers who have used it report a high degree of satisfaction with the assistance that the tool provides with the difficult task of employee evaluation and counseling. Employees receive a less subjective evaluation of their performance and have definable goals that can be achieved to improve their performance. Outstanding employees no longer feel that their valuable contributions are ignored, which adds to nurse satisfaction. References 1. Longnecker CO. Key managerial competencies for valueadded appraisals. J Comp Benefits. 2011;27(5):11-18. 2. Atchison TJ. Installing Pay for Performance, Management Today: Managing Work in Organizations. Boston, MA: Houghton Mifflin Harcourt; 1978. 3. Smith K. Reinvigorating performance evaluation: first steps in a local health department. Publ Health Nurs. 2010; 27(5):425-432. 4. Froydis VA. Employee’s perceptions of justice in performance appraisals. Nurs Manage-UK. 2010;17(2): 30-34. 5. Studer Q. Hardwiring Excellence: Purpose, Worthwhile Work, Making a Difference. Gulf Breeze, FL: Fire Starter Publishing; 2003.
PERIOPERATIVE EMPLOYEE EVALUATIONS 6. Kalisch BJ. Risk management. The impact of RN-UAP relationships on quality and safety. Nurs Manage. 2011; 42(9):16-22.
John Olmstead, MBA, RN, CNOR, FACHE, is the director of surgical services and the emergency department at The Community Hospital, Munster, IN. Mr Olmstead has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article. Deborah Falcone, RN, is the manager of the surgery department at The Community Hospital, Munster, IN. Ms Falcone has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article. Jacy Lopez, RN, is the assistant manager of the surgery department at The Community
www.aornjournal.org
Hospital, Munster, IN. Ms Lopez has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article. Lorraine Sharpe, RN, is the manager of the same day surgery department and gastrointestinal laboratory at The Community Hospital, Munster, IN. Ms Sharpe has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article. Jody Michna, RN, is the manager of the postanesthesia care unit at The Community Hospital, Munster, IN. Ms Michna has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article.
AORN Journal j 633