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PERFORMANCE MANAGEMENT (PM) IN HOSPITALS.
Term Paper ID:29987
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Essay Subject:
Discusses how human resource management (HRM) uses the PM system to improve the organizational performance of a hospital.... More...
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18 Pages / 4050 Words
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Paper Abstract:
Discusses how human resource management (HRM) uses the PM system to improve the organizational performance of a hospital. Defines PM programs & their relation to standards and resources. Contends that strategic HRM is integral to PM to ensure that standards are met. Factors that determine quality of patient care. PM in health care. Issues in hospital HRM. Role of Information Technology (IT).
Paper Introduction:
Performance Management in Human Resource Management:
The Case of Hospitals
Introduction
Performance Management (PM) is a system composed of an orderly series of programs designed to define, measure, and improve organizational performance (Katz & Green, 1997). It is a system developed to ensure compliance with requirements, that is, that staff are in compliance with written standards. PM uses the tools of statistical process control to form the basis for decisions about change. It incorporates the processes of performance awareness, performance measurement, and performance improvement.
Successful PM requires the creation, maintenance, use, and evaluations of mechanisms to define and revise standards and to
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Health Care Systems EconomicsReport, 1(9), 2-6. Home Health Outcomes &Resource Utilization, New York: National Leaguefor Nursing. Hudson (1999, p. Appraisals C. and Rose, V.L. Edwards Deming, whose insights on the importance of quality andthe ways of achieving quality management are as useful in health servicedelivery systems as they are to manufacturing systems. (1998). Included in thekey indicators of CQI in the hospital are such matters as patientsatisfaction with pain management, maintenance of skin integrity, andpatient satisfaction with care. Sederer, L.I., and Dickey, D. In certain settings, particularly when employees aremembers of unions, pay for performance has failed to receive widespreadacceptance. Moran, N.Y. Specifically, many hospitals have adopted behaviorally anchoredemployee rating scales as an alternative to traditional appraisalmethodologies. Rosenbluth and Peters (1992) identified several education strategiesthat health care organizations and HRM leaders should consider as theyimplement PM and reengineer for the future. In the health care setting, HRM is directly responsible for thecreation and promotion of effective employee recognition programs. Rosenbluth, H.F., and Peters, D. PM. Designing a system for managing the performance of mental healthmanaged care. (1998). Effectiveness, or the degree to which the care is provided in the correct manner to achieve desired outcomes. Government agencies in the United Statesinstituted the Performance Management and Recognition System as early as1984 as a means of establishing a pay for performance system and to improveindividual and organizational effectiveness (Kingsbury, 1993). Shindul-Rothschild, J. It speaks directly to issues related to quality and such traditionalquality-oriented tasks as quality assurance, quality control, andcontinuous quality improvement (CQI). Job descriptions are integral to the governance and practicedomains, while employee development plans and documentation of employeeactivities are included in assessing and analyzing practice and practiceresults. Joint Commission on Accreditation of Healthcare Organizations.(1993). The role of HRM in hospital settings is multifaceted, involving a CQIfunction that includes collection of data related to patient outcomes,nature and type of care delivered, compliance with external norms andstandards, patient assessments, and record maintenance. Notonly will HR have to take a lead role in training workers for IT; it willalso have to "train the trainers" to capitalize upon emergent technologies.IT has affected literally all aspects of corporate life and work, and HRhas its own internal challenge to meet in mastering this technology. Lifelong learningopportunities - internally within the firm and via colleges anduniversities, company-funded workshops and seminars, other developmentprograms - are being used by HR to simultaneously enhance job satisfaction,reduce costs, and link incentives and rewards to actual company needs andconcerns (Goldberg, 1998). Measure and motivate performance improvement. Companies train sights on improved training. PM isintimately connected to CQI, and thus challenges in HRM's participation inthis process are readily apparent. Katz and Green (1997) believe that the key HRM functions in termsof performance appraisals include creating a framework for change in whichthe performance management system becomes one of shared leadership. Targeted rewards jump-start motivation.Workforce, 77 (2), 88-94. This may well be the core of HRM activities in aPM system. Role of Human Resources Management (HRM) in PM C. Using the correct performance measuresand reviewing performance measures against organizational service goals iscritical. Anonymous. Personnel Review, 26 (5-6), 467 - 485. GE Marquette. (1999). Campbell-Heider, N., Krainovich-Miller, B., King, K.B.,Sedhom, L., and Malinski, V. A critical aspect of training will be technology-driven and intensive, with Web-based resources a key element. Lifelong learning in the workplace.Connection: New England's Journal of Higher Education &Economic Development, 12(2), 23 -26. are currently dissatisfied with their current training anddevelopment systems and want to improve them, positioning HR as the logicalfocus for such an effort. Institute a leadership development program and staff education for new products and methods. The role of HRM in ensuring that these standards are met and each ofthe factors which JCAHO identifies as essential are addressed, isincreasingly important. By integrating the appraisal system into performancemanagement, the program creates organization-wide behavioral expectationsand identifies areas in which improvements in quality are required. Campbell-Heider, Krainovich-Miller, King, Sedhom, and Malinski (1998)have also noted that what is currently lacking in most nursing CQI programsis adequate training of nurses to collect the kind of data needed formeaningful analysis of patient outcomes. The two components include standards/specificationsand scope. HRM has become an increasingly significant player in thedesign, development, implementation and management of performance. Campbell-Heider, Krainovich-Miller, King, Sedhom, and Malinkski(1998) described the American Nurses Association (ANA) position on CQI andrelated matters, commenting that ANA has recommended the establishment of anational data base which can collect, aggregate, and analyze patient datato link nursing activities to specific quality of care outcomes. (1997). In the context ofthe hospital, CQI as part of an ongoing organization-wide Quality Assurance(QA) and Quality Improvement (QI) effort is often inclusive of actions suchas listening to the customer (or patient), focusing on processes thatresult in positive outcomes for the customer, and using data to determinewhether changes have satisfied the customer's needs (Reese, 1997. In the Blueprint for Performance Management developed by Katz andGreen (1997), HRM in the hospital setting participates in three specificdomains: service, practice, and governance. Standards direct workers toward the kinds of activities they mustmaster in order to meet organizational and accreditation goals andobjectives. The three major programs are performance awareness, performancemeasurement, and performance improvement. Proper and appropriate accountabilitythrough PM is a key strategy for maintaining quality as a significantaspect of care. This includes involving senior management and employees, andincluding both groups in setting goals and developing appropriateperformance appraisal strategies. HRFocus, 75 (11), 4. (1997). Threedimensions of care are addressed in the package: potentially avoidableadverse outcomes, potentially inappropriate use of hospital inpatientprocedures, and potentially avoidable hospital admissions. Nurses are required to work with protocolsthat address these and other key indicators, but staff nurses in suchsettings often report that they perceive themselves to be ill-prepared withrespect to the specific indicators, the protocols themselves, datacollection and analysis, etc. Carpinello, Felton, Pease, DeMasi, and Donahue(1998) identifies three goals that have served to guide both thedevelopment and the testing of the PM system in the health care field: . Nurses week tribute: A nursing callto action. Contemporary LongtermCare, 2 (11), 69-71. These are directcosts only and do not encapsulate the costs for staff time of staff membersnot working in a designated quality department. Martin, M.E. Nursing Science and Research in the Nordic Countries, 18(3),47-51. Managers' perceptions of strategicHR change. How technology will change theworkplace.Workforce, 77 (1), 78 -83. Issues in Hospital HRM/PM A. Their willingnessto participate in CQI is directly influenced by their own perception ofpersonal and professional competency to perform these data collectiontasks. HR plays a critical role in this area byidentifying employee needs and linking those needs, the company's ownconcerns, and cost-effective and carefully targeted learning opportunities.Tuition reimbursement is but one way that HR is accomplishing its across-the-board mission of facilitating the development of a technologicallycompetent, motivated workforce (Goldberg, 1998). Given these costs, itbecomes readily apparent that much more needs to be done to ensure thatstaff in hospitals will be appropriately trained to participate inmeaningful CQI activities. Katz and Green (1997) emphasize the importance of organization-wideeducation in the HRM function in PM. H&HN: Hospitals & HealthNetworks, 73(8), 32-33. Holter (1998) has noted that patient-driven quality which puts thepatients and all their needs in focus must remain a core concern of anynursing CQI approach. Mears, P. Boca Raton, FL: St.Lucie Press. Holter, I.M. SamuelGreengard (1998) has stated that computers have automated and come tomanage almost every type of process-succession planning, training, skillsdevelopment, retirement and government compliance - all functions in whichHR is intimately involved. Commit the educational resources necessary for the hospital - both financial and in terms of time.Additionally, HRM in the hospital setting is encouraged to implement aninformation management system that facilitates hiring, performanceappraisals, and training (Rosenbluth & Peters, 1992). Managing Quality: A Guide to System-wide Performance Management in Health Care. It incorporates the processesof performance awareness, performance measurement, and performanceimprovement. TheHealthcare Cost and Utilization Project Quality Indicators (HCUP QIs) aredesigned to help nurses assess inpatient outcomes by screening dischargedata and identifying clinical areas appropriate for analysis. (1997). Hudson (1999) reported that the National Hospital Quality ImprovementSurvey revealed that as of 1998, hospitals appeared to be averaging annualcost savings of $25 , . Healthis now viewed as a market commodity and even in the United States, whereadvanced medical technology and practice have reached a plateau unrealizedthroughout much of the world, cost-effective care has become a necessaryconcern. Efficiency, or the ratio of outcomes for a patient to the resources used; . Thisstrongly supports the assertion that while CQI is viewed by health serviceproviders and HRM as an important approach to delivering high qualitypatient care, the transition from a valued theory to an established, widelyused set of practices and policies has not been accomplished as yet. References----------------------- 1 This program included the implementation of a set ofperformance outcomes in workers' job descriptions along with training andeducation of staff members to achieve these outcome measures. . Outcomes Assessment inClinical Practice. HR Focus (1997) recently reported that five of 1 companies inthe U.S. Training and IT A. In terms of theorganization itself, HRM's contributions to PM facilitate increased controlof department functions, increased coordination of services, and improveduse of human resources.Issues in Hospital Human Resource Management Despite continued pressures to cut costs, a recent survey by Deloitte& Touche LLP revealed that few U.S. HRM. The literature will be examinedto demonstrate that performance management has evolved as one of thecritical tasks of human resource management in this particular worksetting.Performance Management and Quality The JCAHO outlined twelve factors that determine the quality ofpatient care and define these factors as dimensions of performance.Specifically, these nine dimensions are: . Safety, or the degree to which risk is reduced for the patient and providers; . PM in Hospitals and Health Care A. Implementation of asuccessful PM system requires education of all employees in every facet oftheir employment. Canadian Oncology Nursing Journal, 7(3), 14 -143. Capowski (1998) has commented that many HR professionals are usingsuch mechanisms as skill-based pay (a direct artifact of the ITrevolution!) to challenge and motivate employees to increase theirknowledge. hospitals are experiencing significantdownsizing or staff layoffs (Grand Rapids Business Journal, 1997). The role ofhuman resource management (HRM) within organizations and its relationshipwith organizational performance and business strategy has received a greatdeal of attention in the past decade (Kamoche, 1994). In this general context, training will take on added significancewithin HR. Deficits and ChallengesVI. Health care organizations that offertheir employees career-long education and an environment in which to use itwill invariably experience PM improvements. Available at http://www.marquette-hellige.com/resource/perspectives/chestpain/ Goldberg, R. Thedefinition of quality in health care has evolved over time from an initialfocus on the technical aspects of quality to a renewed emphasis on levelsof excellence produced and documented in the process of patient care.Under the aegis of the Joint Commission on Accreditation of HealthcareOrganizations (JCAHO), quality is defined as the degree to which patientcare services increase the probability of desired outcomes and reduce theprobability of undesired outcomes given the current state of knowledge(Katz and Green, 1997). Availability, or the degree to which the appropriate care is available to meet patient needs; . Goals of PM in HospitalsIII. Continuous Quality Improvement (CQI) is defined as continuousimprovement in satisfying customers and reducing variation in the productsor services produced (Mears, 1997). Rewards/IncentivesV. Skinner, D., and Mabey, C. Greengard, S. Workplace flexibility, the advent of thevirtual office and technology-driven workplace shifts implicit intelecommuting and videoconferencing and e-mail as a replacement for face-to-face interactions are effects with which HR has come to terms in shortorder. Theynoted that CQI programs are needed in order for nurses to document whetheror not nursing care in a particular institution or unit meets predeterminedstandards of excellence. Currently, hospitals areupgrading benefit packages and extending programs to other segments oftheir employee population. Employees that constantlylearn and incorporate new ideas and techniques into their jobs, become avital and dynamic force for change. To combine existing process data with new consumer- and clinician-reported status outcomes data into a comprehensive, integrated database to serve as a one-stop platform for performance analysis and reporting. Respect and caring, and the involvement of the patient in caredecisions; . (1997). Restatement of HRM roleVII. These suggestions are: 1. The Customer Comes First andother Secrets of Exceptional Customer Service. (1997). Open dialogues with employees (Grand Rapids Business Journal, 1997). and Malone, M.P. CQI tool released. The New YorkState program included HRM in assessing administrative efficiency andemployee performance. Quality checkup. (Moran & Malone, 1997; Shindul-Rothschild,1998). (1992). Utilizing patient satisfactionto meet the challenges of managed health care. This Blueprint impacts upon staff by increasing participation indecision-making, increasing autonomy and control of practice, andincreasing accountability (Katz & Green, 1997). The highly competitive environment of the contemporaryhealthcare sector and reform in healthcare finance together coalesce tomandate CQI efforts and to create a climate in which services arecompensated when anticipated patient outcomes are forthcoming. Documentation of services and demonstrated proof ofservice efficacy are clearly here to stay. Macartney, G.M., Stone, G., Harrison, M.B., Graham, I.D., andGrasse, C.E. Katz, J.M., and Green, E. . This same researcher that the three topconditions or procedures for which hospitals or nurses collect and use datalinked to CQI are coronary artery bypass surgery (94 percent), acutemyocardial infarction (8 percent), and C-Section surgical procedures (76percent). The move will, it is anticipated, involve shifts from thevertical to the horizontal organizational structure; HR will have to ensurethat managers have the skills needed to lead workers into the nextmillennium. To employ the database and information products in guiding management decision-making.This model envisions PM in the health care setting as a continuousmechanism for selecting critical performance areas and indicators,measuring and analyzing actual performance, and maximizing meaningful useof performance information (Carpinello, et al, 1998). Health care's continuous qualityimprovement strategies demand responsive technologiesand systems development. Standards of JCAHO B. With hospitals challenged to resist the reductionist impetus ofeconomically-based and commercially driven approaches to healthcare, HRMsmust nevertheless recognize that these are insistent imperatives to whichit must respond (Parker, 1999). . (1999). Designing anew PM system that incorporates appraisal has proven to be difficult atbest, but many contemporary programs attempt to establish a link betweenpay and performance. While employee-driven quality which seeks to meetstaff needs for purpose and meaning in their work and economic-drivenquality as a measure of how the organization meets its economic obligationsare important, Holter (1997) stresses that HRM must recognize that it isthe patient who is the primary focus of CQI activities. (1998). Katzand Green (1997) include five key elements in effective employeerecognition programs: recognition symbols, display options of visible signsof achievement, meaningful presentations, program promotion, and frequentmodification of recognition rewards. In addition to the traditional purposes ofpromotion, compensation, and discharge decisions, performance appraisalsare increasingly used by hospital HRM professionals to: . The concept of CQI emerges from thework Dr. W. Getting to know oncology inpatientsand their families. It's what you know." HR Focus, 75 (6), 2. It is this function of HRM that will be discussedin this report. (1997). Measuringperformance of staff members, developing benchmarks for performance alongthe lines created by positions and job descriptions, linking performanceand quality improvements to training and education of workers, anddeveloping recommendations for organizational growth are all functionsattributed to HRM in a PM system (Sederer & Dickey, 1996).Performance Management in Health Care In the health care environment, an effective performance managementsystem is composed of two critical components and three major programs(Katz & Green, 1997). HRMprofessionals play key roles in all PM committee and team activities. A Blueprint for PM in HospitalsIV. Efficacy, or the degree to which care accomplishes desired outcomes; . Carpinello, S., Felton, C.J., Pease, E.A., DeMasi, M., and Donahue,S. PM uses the tools of statistical process control toform the basis for decisions about change. (1996). InformationWeek, 738, 125. Introduction and Purpose A. and Goodrich, G.E. Louis: Mosby. In this context, Martin and Goodrich (1997) have recommended thathuman resources management should implement an outcome based CQI systemwhich thoroughly trains staff on several key issues: 1) the identificationof key indicators relevant to QA standards imposed by the Joint Commissionon Accreditation of Healthcare Organizations (JCAHO) on healthcareproviders; 2) analysis of the effectiveness of internal systems ofhealthcare delivery; and 3) condition-specific measures of outcomeachievement and service efficacy. Anonymous. Other issues facing today's HRM professionals in the health settingare plans for educational reimbursement of workers, lifelong learningprograms (a critical factor in worker retention and morale/motivationbuilding), and new methods of motivating employees and offering meaningfuland valued incentives (Laabs, 1998). Thissurvey identified the main challenges to HRM departments in hospitals, eachof which relates to some of the central tasks of performance management.The major concerns included employee morale levels, the impact ofdownsizing, managing benefit costs, staff retention, and the introductionof pay for performance systems. It is a system developed to ensurecompliance with requirements, that is, that staff are in compliance withwritten standards. To develop and disseminate information products derived from the data for internal and external use. Appropriateness, or the degree to which care is relevant to the patient's clinical needs; . Empowering staffnurses to participate in the ANA's call for quality indicators research.Journal of the New York State Nurses Association, 29(3/4), 21-27. A study by Carpinello, et al (1998) explored the development,implementation, and early results of a comprehensive performance managementsystem for public sector managed behavioral health care. Laabs, J. On average, hospitals are spending $2 1, on all internalCQI/TQM activities at an average cost of $1,167 per bed. Patient Care D. Targeted rewards monetary andotherwise) are now being employed more commonly to initiate and sustainmotivation; rewards are being linked to specific performance measuresreflecting the firm's vision, mission, values and goals. 3. Recognize that education must be attitudinal as well as technical. 32) recentlyreported that with most hospital quality programs, "the reach is broad, notdeep." The National Hospital Quality Improvement Survey, which collecteddata from 1,928 American hospitals, found that 93 percent of allrespondents were using CQI or total quality management (TQM) methods;however, the survey also revealed that only 35 percent of hospital staffmembers (and 22 percent of doctors) are trained in CQI or TQM methods.Additionally, CQI team participation is limited to about 21 percent ofhospital professionals, though 79 percent of all responding institutionsstated they had a separate CQI/TQM department (Hudson, 1999). Timeliness, or the degree to which the care is provided at the appropriate time (JCAHO, 1993).In this general context, human resources is particularly important in thatit serves as a locus for establishing the standards and performanceindicators that will assist in determining performance achievement (Skinner& Mabey, 1997). AHCPR has created and is now making available a free computersoftware tool for routine self-assessments of inpatient care. This situation mandates theimplementation of PM and a strong role for HRM. Position education as an essential part of the health care organization. Issues to be examined include the overall importance of PMin strategic HRM, the rationale for implementing PM, the advantages,disadvantages, tasks, and goals of PM, and the relevance of PM in thespecific environment created by hospitals. Performance Management. While mostcompanies (6 percent) tend to rely on externally developed trainingprograms, these new technologies and IT in general are mandating that HRdevelop company and application-specific training and development modulesfor managers and workers. An organization-wide process ofemployee recognition is a powerful indicator of worker satisfaction and canbe used as a benchmark of excellence of the health care organization'sperformance. (1998). Greengard posits a strategic role for HR as the new technologies(including Intranets and the Internet) force HR to look at human assets inbusiness terms; HR executives will be asked to quantify processes andpresent a business case for making changes to an organization and itsstaffing. Building workersatisfaction can be enhanced by the use of this kind of information, whichshould be linked to effective employee recognition programs. Washington,D.C.: United States General Accounting Office. Making performance management work.Executive Edge Newsletter, 28 (7), 15. . American Journal of Nursing, 98(5), 36. 2. Purpose of Study: Centered in HospitalII. Whenperformance appraisals were conducted, HRM used the framework created bythis system to assess employee skills, competencies, and achievements.Simultaneously, the framework provided for the identification of serviceimprovement needs and helped HRM create more effective reward and incentivesystems for workers. Kingsbury (1993) states that the goal of any effective performanceappraisal strategy is to recognize that the fundamental purpose of theappraisal is to improve organizational performance and not to penalizeworkers. Summary and Conclusions A. The ABCs of CQI. In such disparate settings as salesorganizations, hospitals, automobile and other manufacturing facilities,and schools, PM is a vital element of a cross-sectional, organization-widestrategy for coping with uncertainty, managing change, and "growing" anorganization while satisfying client and customer needs (Skinner & Mabey,1997). To make PM work, several steps must be completed with the assistanceof HRM. Kingsbury, N.R. Inherent in the drive to demonstrate quality andcost-effectiveness of care is the need to support the value of a service -another function that is integral to PM and HRM in the new managed careenvironment. Collegian: Journal ofthe Royal College of Nursing - Australia, 6(1), 16-23. Performance Management in Human Resource Management: The Case of HospitalsIntroduction Performance Management (PM) is a system composed of an orderly seriesof programs designed to define, measure, and improve organizationalperformance (Katz & Green, 1997). The Measurement Mandate. Purpose and Goals C. Thisreport has examined the critical elements of HRM's role in PM in thecontext of the hospital environment - an environment particularly focusedon improving and managing performance. (1998). (1998). Efforts to reform third-party payment systems and to institute anational health insurance plan have largely been frustrated, and what hasresulted is closer scrutiny of service delivery, professional practices,and patient outcomes. (1998). (1997). Nurses are generally the mostlogical healthcare provider to be assigned the task of collecting andrecording patient outcome, assessment, and service data. Providing and communicating feedback on performance results -often through the performance appraisal process itself - is necessary inorder to assist all staff members in continuously improving their own jobperformance and meeting organizational goals (Executive Edge Newsletter,1997). (1997). Successful PM requires the creation, maintenance, use, andevaluations of mechanisms to define and revise standards and to informthose affected by the standards about them (Katz & Green, 1997). These scales have the capacity to encourage an objectiveapproach to evaluating individual effectiveness, which is perceived asincreasingly important as hospitals contend with employee morale issues(Grand Rapids Business Journal, 1997). (1998). Performance management in health care can further be defined as a setof systematic methods for assessing and improving the outcomes associatedwith a health care plan. Given the new managed care environment,HRM has been forced to recognize the necessity of creating effectiveincentive systems for worker retention and satisfaction whilesimultaneously keeping costs to a minimum. 4. Workers are rewarded with higher pay and even tuitionreimbursement when they succeed in improving skills and knowledge anddemonstrating the productivity effects of such improvements. (1998). The scope of standards in a health care setting defines theroles of employees and managers, while the performance management systeminvolves HRM in both performance appraisals and measurement and performanceimprovement via training and education (Katz & Green, 1997). Chicago: JCAHO. GE Marquette (www.marquette-hellige.com/resource/perspectives/chestpain) notes that CQI has a dual focus - improving care while stilldecreasing costs. However, the system can be used to identify employees who haveachieved benchmarked performance standards and have provided excellentservice to both their organization and to their clientele. HR managers For the net. (1997). For HRM,CQI has assumed enhanced significance in light of the debate over healthcare, which includes discussion of cost-effective service delivery as wellas various approaches to production of quality (for patients, in a clinicalsense, for employees) (Holter, 1998). Healthcare Teams. Parker, J.M. Capowski, G. New York: William Morrow. Standards and Scope B. Katz and Green (1997) have commented that PM in thehealth care or hospital environment is inextricably linked to quality. PM and Quality A. Description of Performance Management (PM) B. Education D. Mateyaschuk, J. The drive forenhanced organizational performance and the need for integrative practicesthat are aligned to and support the organization's primary strategicobjectives has linked HRM to other organizational and business activitiesand strategies. (1993). Impact of implementing anoutcome based quality improvement system. References Anonymous. Patient or customer? Information Technologies (IT) and their Impact B. Reese, D. Strategic human resource management is integral to PM. Theinstitution benefits by acquiring greater flexibility in its workforce andgreater value added to their human assets.PM, Training, HR and Information Technologies (IT) Information technology (IT) has forever changed the workplace. Hudson, T. Sweeney andRose (1998) have commented that this kit is free of charge and can beobtained easily from AHCPR, suggesting that healthcare institutions haveaccess to extremely affordable educational and data collection programsthat would greatly facilitate CQI activities and the role played by HRM.Summary Parker (1999) states that contemporary healthcare institutions andtheir professional staff are being confronted with the global imperative ofincreasingly rationalization of care based on an economic ethic. HRM is also responsible for assisting in thedevelopment of practice guidelines that are linked to workers' jobdescriptions and also speak to performance analysis as well as satisfactionanalysis. Survey studies hospital human resource issues.Grand Rapids Business Journal, 15 (24), B9. Generally, the purpose of human resources (HR) performance appraisalsis to improve and assess an individual's performance and thereby enhanceorganizational effectiveness. OUTLINEI. Baltimore: Williams & Wilkins. Transformational leadership and qualityimprovement. St. Role of HRM B. Sweeney, R. (1999). AmericanFamily Physician, 58(8), 173 . Journal of Behavioral Health Services & Research, 25 (3), 269-279. (1999). One example of this paradigm shift was identified by Mateyaschuk(1999), who reported on an intranet HR software program calledKnowledgePoint that helps personnel managers, including IT managers, trackemployee performance and write performance reviews and evaluations. This type of staff has the capacity toassimilate change and comes to possess the personal power needed to copewith the ambiguity that often accompanies change. With respect to service, HRMis responsible for developing the job descriptions that serve as the basisfor performance analysis. (1998). Continuous Quality Improvement (CQI) C. Continuity, or the degree to which the care is coordinated among practitioners, between organizations, and across time; . Itrequires the judicious deployment of fiscal, human, and material resources. Again, this presents a training and education challenge to HRM thatneeds to be addressed as part of an ongoing PM effort.
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