CONTROLLING
Quality Control, Performance Appraisal,
Staff Development and Problem Employees
Prepared by:
John Ian E. Amigo, RN, LPT, MAN
Shem Marie Fideles Chu Daños, RN, MAN
Controlling phase of the management
process is measured against predetermined
standards and action is taken to correct
discrepancies between these standards and
actual performance
Quality Control- a specific type of
controlling, refers to activities that are used to
evaluate, monitor, or regulate services rendered
to consumers.
Quality Control as Process
The Development of Standards
Standards is a predetermined level of excellence that serves as a guide for
practice.
Standards for practice define the scope and dimensions of professional nursing.
Organizational standards outline levels of acceptable practice within the
institution.
Standardized clinical guidelines provide diagnosis-based, step-by-step
interventions for providers to follow in an effort to promote high-quality care.
Standardized nursing language provides a consistent terminology for nurses to
describe and document their assessments, interventions, and the outcomes of
their actions.
Sample Standardized Nursing
Languages and Measures
§ Nanda International § Systematized Nomenclature
§ Nursing Interventions Classification Medicine Clinical Terms
(NIC)
§ Nursing Outcomes Classification § Logical Observation Identifiers
(NOC) Names and Codes (LOINC)
§ Clinical Care Classification System § Nursing Minimum Data Sets
(CCC) (NMDS)
§ The Omaha System § Nursing Management
§ Perioperative Nursing Data Set Minimum Data Sets
(PNDS)
§ International Classification for § (NMMDS)
Nursing Practice § ABC Codes
§ (ICNP) § Patient Care Data Set (retired)
Audits as a Quality Control Tool
An audit is a systematic and
official examination of a Outcomes can be defined as the
record, process, structure, end result of care
environment, or account to
evaluate performance.
Process audits measure how nursing care
is provided.
Structure audits assume that a relationship
exists between quality care and appropriate
structure.
Quality
Improvement
Model Total Quality
Management
Assumes that production
and service focus on the
individual and that quality
can always be better.
Create a constancy of End the practice of
purpose for the Adopt a philosophy of Focus on improving awarding business on price
processes, not on alone; instead, minimize
improvement of continual improvement. inspection of product. total cost by working with a
products and service. single supplier.
Drive out fear by
Improve constantly every
Institute job training and Develop the leadership in encouraging employees to
process for planning,
retraining. the organization. participate actively in the
production, and service.
process.
Promote teamwork rather
Foster interdepartmental Focus on quality and not
Eliminate slogans, than individual
cooperation, and break just quantity; eliminate
exhortations, and targets accomplishments. Eliminate
down barriers between quota systems if they are in
for the workforce. the annual rating or merit
departments. peace.
system.
Educate/ train employees to Charge all employees with
maximize personal carrying out the TQM
development. package
Reporting and Analyzing Errors
critical strategy for addressing errors in the
Medical health-care system is the need to increase both the
mandatory and voluntary reporting of medical
Errors: An errors.
Ongoing The Leapfrog Group
identified four evidence-based standards that
Threat to they believe will provide the greatest impact on
Quality of reducing medical errors.
Computerized physician-provider order entry
Care Evidence-based hospital referral
Intensive care unit physician staffing
National quality forum-endorsed safe
practices
a statistical measurement that
Six Sigma Approach and Lean reflects how well a product or
Manufacturing process is performing.
need to change for employees and
Reforming the Medical Liability patients to be comfortable in
System reporting hazards that can affect
patient safety without fear of personal
risks.
Let employees know the level of
their job performance as well as
any expectations that the
organization may have of them.
Using the
PERFORMANCE
merit rating,
Performance was tied fairly
closely to
APPRAISAL Appraisal to
Motivate Employees
salary
increases.
Performance evaluation, implies
the personal values in which being
placed in the performance review.
Strategies to Ensure Accuracy and
Fairness in the Performance Appraisal
The appraiser should Accurate record keeping
develop an Data should be is another critical part of
Consultation should
awareness of his or gathered ensuring accuracy and
be sought frequently. fairness in the
her own biases and appropriately.
prejudices. performance appraisal.
critical incident recency effect, favors
recording, evaluates appraisal of recent
both positive and performance over less
negative performance recent performance
behavior throughout the during the evaluation
performance period period.
Collected Performance appraisals
assessments should The appraiser should always include
contain positive Some effort must be needs to guard Reviewers need to
asking the employee how
made to include the against three guard against a bias
examples of growth the organization or the
employee’s own common pitfalls of known as the manager can make work
and achievement
and areas where appraisal of his or assessment. halo Matthew effect. easier to achieve better
effect, horns effect, quality, greater volume,
development is her work. and improved outcomes.
needed. central tendency
halo effect occurs when horns effect appraiser Matthew effect, when
the appraiser lets one allows some negative employees receive the
or two positive aspects aspects of the central tendency, the
of the assessment or same appraisal results,
employee’s performance manager is hesitant to
behavior of the to influence the risk true assessment year after year.
employee unduly assessment to such an and therefore rates all
influence the extent that other levels employees as average.
employee’s of job performance are
performance. not accurately recorded.
Performance Appraisal Tools
r a n in d iv id ua l h a s the
e n t e va lu a te s w heth e th e ta sk ,
nc e a ss e s sm nce to pe rf o rm
A compete u c a ti on , s k il ls, o r ex p e ri e
e ll tha t ind iv id ual
knowled g e , e d ati o n e xa mines h ow w
a n c e ev a lu
whereas a perfoterm s th a t task.
a ctua ll y co m ple
Trait rating scale, a me
thod of rating a person
be the job description, d against a set standard,
esired behaviors. which may
Job dimension scale re
quire that a rating sca
classification. le be constructed for
each job
Behaviorally Anchored
Rating Scales require
developed for each job that a separate rating
classification. form be
Checklist, has several types as appraisal tool.
weighted scale, the most frequently used, composed of many
behavioral statements that represent desirable job behaviors.
forced checklist, requires the supervisor to select and
undesirable and desirable behavior for each employee.
simple checklist, comprises numerous words or phrases
describing various employee behaviors or traits.
Essays is often referred to as the free-form review; narrative form an
employee’s strengths and areas where improvement or growth needed.
Self-Appraisals, employees are increasingly ask to submit written
summaries of their work-related accomplishments and productivity.
Indeed, self-assessment is an important part of reflective practice ( the
assessment of one’s own practice to identify and seek learning
opportunities to promote continued competence.
Peer review, when peers rather than supervisors carry out
monitoring and assessing work performance.
360-Degree Evaluation, includes an assessment by all individuals
within the sphere of influence of the individual being appraised.
COACHING AS PART OF THE PERFORMANCE APPRAISAL
PROCESS
a re aw a re t h a t
r a n d a st ute le a der
e ef fe c t iv e m a na ge is o n e of t he
Th r d in g p e r f orm a nc e
c k re g a
day-to-day feedba ro v in g w o r k p e r fo r m a nc e a nd
e t h o ds fo r im p
b e st m
a te a m a p p ro a c h .
building
STRATEGIES FOR
BECOMING AN
EFFECTIVE COACH
