One of the most popular terms in contemporary organizational management terminologies is Performance Management. Performance is widely known as the outcomes of work done by employees of a company and it provides a very strong linkage between customer satisfaction and strategic goals of an organization (Vlieland, 2009). Many organizations achieve their strategic goals through performance management measurement. Today’s health sector is characterized by numerous changes such as the need to integrate technology into health care delivery and pressure to reduce management costs, both of which require physicians and nurse leaders to re-examine their performance evaluation systems. A growing number of healthcare professionals have adopted the Balanced Score card as their Performance Management Tool (Vlieland, 2009). The purpose of this paper is to describe the Performance Management process in an outpatient Family Practice clinic setting. Information provided in this paper will provide nurse leaders with the necessary skills and expertise they need to manage in the healthcare setting and understand the unique aspects of nursing leadership.
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The population being addressed in this Performance Management tool is a group of families with diabetes seeking health care services in a Family Practice clinic setting. Diabetes is a common health problem among several families around the world. In the United States alone, close to 24 million people are suffering from diabetes (Miller and DiMatteo, 2013). Patients are required to adhere to their treatment regimen in order to manage their diabetes successfully. A number of factors may affect the ability of a diabetes patient to adhere to treatment and they include lack of social support and treatment expectations. The complexity of diabetes management now calls for the great need of support and provision of clear treatment guidelines by nurse leaders to patients in order to reduce the number of deaths that occur as a result of diabetes infection (Miller and DiMatteo, 2013). A nurse leader is charged with the responsibility of ensuring that the desired outcomes are achieved. A performance data scorecard will assist the nurse leader to perform his or her roles effectively.
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Outcome measures in an outpatient Family Practice clinic setting are patient-focused endpoints that describe the nature of health care delivery systems in the facility. These are often the cost and quality targets that an organization is aiming at improving and which are the point of focus for a nurse leader. Outcome measures are described based on different indicators. The four indicators that are used in this paper include performance, quality, patent-safety, and employee engagement. A number of outcome measures can be used to analyze whether employees in the outpatient Family Practice clinic setting are performing as required. One of the outcome measures related to performance is length of stay. The length of time that diabetes patients take at the facility is a very good measure of employee performance. Another example of outcome measure that can be used to examine performance indicator is the percentage of patients that is satisfied with the services they receive from the facility (Spath, 2009).
The outcome measures in the outpatient Family Practice clinic setting that are related to quality include ability of patients to return to work and unplanned return to the facility following an initial visit to the facility. As far as patient safety is concerned, the nurse leader will monitor two outcome measures namely nosocomial infection rates and availability of demarcated regions for patients with disabilities. Patient safety is a very good indicator for determining whether employees are performing well. When analyzing employee engagement indicator, the nurse leader will assess rate of employee turnover and the volume of work available to be accomplished by employees. When using outcome to measure performance in a health care setting, the nurse leader should develop an adjustment system that will relate health care delivery system to the outcome (Spath, 2009).
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Process measures are the individual steps that affect a specific outcome metric either positive or negatively. For instance, if the outcome measure is length of stay, the necessary process that needs to drive it faster processing of the patient’s documents to ensure that limited time passes between time of registration and when the patient leaves the facility. Employee performance can be analyzed by examining the average time that diabetes patients take between arriving at the facility and when they receive the care they needed. The percentage of patients that is satisfied with the services they receive from the facility can be determined by the number of patients who come back to the hospital. It is therefore the responsibility of every employee in the facility to ensure that they provide good services to patients in order to enable them make frequent visits (Spath, 2009).
Diabetes patients should be able to return to work after receiving the necessary care from the Family Practice clinic. Additionally, the quality of care they receive will determine the rate at which they make unplanned visit to the clinic. Patients will be able to return to work if employees work hard to offer high quality of care. Furthermore, low rates of unplanned visits to the clinic will be recorded if employees are able to offer high quality of care to patients through close assistance from the nurse leader. According to Spath (2009), health care facilities must always ensure that patients are safe every time they are within a given setting. Nurse leaders must strive to improve those processes that will ensure patient safety. He or she should work with employees at the clinic to prevent patients from acquiring nosocomial infections by ensuring that all areas visited by patients are clean and free from infectious agents. This will help keep the number of patients suffering from nosocomial infections low. Moreover, workers at the clinic must ensure that there are demarcated regions to enhance safety of patient suffering from disability. The main process that drives rate of employee turnover and volume of work is implementation of appropriate motivation strategies. Effective motivation strategies help to enhance employee engagement which eventually helps to reduce rate of turnover and reduces the amount of work that remains unaccomplished (Spath, 2009).
In addition to the four indicators described above, another indicator that would be important for a nurse leader to monitor on a regular basis to drive outcomes as part of the performance data scorecard is efficiency. Efficiency in this sense is the measure of how resources are utilized in the health care setting. A measure of how resources are used in the clinic can easily reflect how services are delivered to patients. Specifically, the nurse leader can analyze all resources used in relation to the health condition of patients (Agency for Healthcare Research and Quality, 2014). According to the Agency for Healthcare Research and Quality (2014, efficiency is often used to measure the relationship between production process and the product itself. When using efficiency as an indicator to measure performance in an organization, it is always wise to measure resources that are used to treat patients with a specific health problem within a given period of time. For the outpatient Family Practice setting, efficiency will be measured based in the amount of resources used to treat diabetes patients within a specified period of time (Agency for Healthcare Research and Quality, 2014).
The performance data scorecard initially created has got a number of benefits for the outpatient Family Practice clinic setting. According to Frost (2007), performance data scorecard contributes to two types of successes in an organization. These are strategic successes and operational successes. Organizations have varied operational and strategic objectives and this explains why there are considerable variations in content, appearance, and complexity of their performance data scorecards. With a well organized performance data scorecard, organizations find it very easy to check their outcome measures in order to determine whether they are performing well. This information also helps organizations to make strategic changes that will help them to perform better in future. The first advantage of the performance data scorecard initially created is that it helps the outpatient Family Practice clinic to improve its performance across all organizational units. Specifically, the performance data scorecard helps employees at the clinic to know how they are doing and to identify what improvements they should make in order to perform better (Frost, 2007).
The performance data scorecard also assists the outpatient Family Practice clinic to determine those strategies that are worth implementing in order to improve its health care delivery system to patients with diabetes. According to Frost (2007), scorecards act as very useful tools that organizations use to translate their strategy into concrete terms and to track implementation of those strategies. It is always possible to track implementation of strategies using performance data scorecards because they are often developed in a way that directs the attention of an organization to the future. Additionally, with a properly organized performance data scorecard, the outpatient Family Practice clinic ensures that it has the right measures. This is advantageous in the sense that, it helps employees to focus only on those measures that are outlined in the scorecard and leaves out what does not belong to it. Other advantages of the performance data scorecard are as follows; it encourages a balanced performance, it helps the nurse leader on behalf of the clinic to point out what is missing, it encourages good management, and they assists managers of the clinic to tell the whole story of the enterprise (Frost, 2007).
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Employee engagement has become a very critical factor for modern employers globally. The complexity of the workforce is gradually changing with the significant changes in organizational structures worldwide. Multinational organizations have now realized that strategies for engagement that they apply in one country may not fit in another country. Employee engagement dynamics may therefore vary significantly depending on the nation in which an organization operates (Brown, 2015). The first current trend in healthcare related specifically to employee engagement is integration of technology into healthcare delivery system. The contemporary world is characterized by numerous technological advancements that variations in patients’ needs that call for the need to use technology in health care delivery. Employees must therefore be in a position to operate the modern technology and know how to use them to deliver quality care in order for them to feel satisfied. The second current trend in healthcare that is related to employee engagement is the need for a diverse workforce that consists of people from different ethnic backgrounds and with varied competency levels. The world comprises of people from different cultural backgrounds and modern health care organizations must take this into consideration when they are making new hires. A diverse workforce that is not discriminated against by the employer will feel engaged and satisfied (Brown, 2015).
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There is a very close relationship between employee engagement and healthcare quality. The goal of every health care organization is to improve patient’s health by offering quality care. According to Sherwood (2013), highly engaged employees display caring attitudes towards their patients irrespective of the health problems they are suffering from. Workers serving in a healthcare organization have the sole responsibility of taking care of their patients and the quality of care they offer is always high when they are fully engaged. In addition, engaged workers are able to identify the level of dedication that their organizations have towards patient care. For this reason, they try to work hard by offering quality care to patients in order to assist their organizations achieve their goals. Furthermore, engaged employees are always interested in using the facility they work for solely for health care provision. They will therefore struggle to offer quality health care in order to give their organizations a good image. As Sherwood (2013), puts it, highly engaged employees formulate measurable goals that will enable them understand how they can perform to help their organization achieve the desired objectives. Every healthcare organization that wants to improve quality must therefore work hard to ensure that its employees are highly engaged (Sherwood, 2013).
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The current too that the organization uses to measure employee engagement is the Performance Management Software. This tool does not adequately provide nurse leadership with data regarding employee engagement. Using the Performance Management software, the organization can easily connect business strategies with employees’ goals and implement programs for each employee that meets the required target. Although the organization can use this tool to provide employees with feedback throughout the year, it does very little in improving employee engagement. Therefore, the organization needs a tool that will increase communication between management and employees as this will adequately provide nurse leadership with data regarding employee engagement (HealthcareSource, 2015).
The following plan is intended to improve employee engagement in the organization;
- To ensure that all employees understand organizational goals and how to achieve them
- To assist employees to understand how their contributions assist the organization to realize its objectives.
- Provide meaningful work for all workers
- Create opportunities for personal development and advancement
- Provide employees with career planning tools.
- Improvement in employee performance
- Enhance efficiency
- High health care quality
- Improves patient safety
- The organization should be able to capture employees’ feedback in real-time
- Employees should be able to demonstrate confidence and trust in the job they do.
- The above named changes should be observed in the organization within a period of three months following implementation of the new tool
In addition to the new tool, the nurse leader should implement best practices that improve employee engagement in order to improve performance in the organization. First, the leader should provide growth opportunities for its employees by organizing training and development programs for them. This facilitated talent mobility and created a high-impact learning culture. Second, the leader should use rewards and benefits as a way of motivating workers. These benefits and rewards should be offered to employees in order to encourage them to perform work hard on the job. Frequently rewarded employees tend to be more engaged than those who are do not receive any rewards and benefits. Third, employee engagement can also be improved through creation of positive work environments. Positive work environments can be created by developing flexible work schedules and by creating a culture of recognition for all workers (Miller, 2014).
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