Performance Management Methods And Practices Among Nurses .
Madlabana et al. Systematic Reviews(2020) OCOLOpen AccessPerformance management methods andpractices among nurses in primary healthcare settings: a systematic scoping reviewprotocolCynthia Zandile Madlabana1* , Tivani Phosa Mashamba-Thompson2 and Inge Petersen1AbstractBackground: Nurses make up the largest constituent of the health workforce. The success of health careinterventions depends on nurses’ ability and willingness to provide quality health care services. A well-implementedperformance management (PM) system can be a valuable asset in ensuring that nurses are motivated, promoted,trained and rewarded appropriately. Despite the significant benefits of effective PM such as improved motivation,job satisfaction and morale, PM systems are highly contested. Therefore, it is important to examine evidence on PMmethods and practices in order to understand its consequences among nursing professionals in primary health care(PHC) settings.Methods: The search strategy of this systematic scoping review will involve various electronic databases whichinclude Academic Search Complete, PsycARTICLES. PsycINFO, Cumulative Index to Nursing and Applied Health Literature,Medline and Cochrane Library from the EbsocHost Database Platform. Electronic databases such as PubMed andGoogle Scholar, Union catalogue of theses and dissertations via SABINET online and WorldCat dissertations will beincorporated. A grey literature search will be conducted on websites such as the World Health Organization andgovernment websites to find relevant policies and guidelines. The period for the search is from 1978 to 2018. Thistime period was chosen to coincide with the Declaration of Alma-Ata on PHC adopted in 1978. All references willbe exported to Endnote library. Two independent reviewers will begin screening for eligible titles, abstracts and fullarticles. During title and abstract screening, duplicates will be removed. The Mixed Method Appraisal Tool willdetermine the quality of included studies. Thematic analysis will be used to analyse the included articles.Discussion: Evidence of preferences on PM methods and practices will generate insight on the use of PM systemsin PHC and how this can be used for the purpose of improving nurses’ performance and in turn, the provision ofquality health care. We hope to expose knowledge gaps and inform future research.Keywords: Performance management, Performance appraisals, Performance review, Nurses, Quality of care, Humanresources management, Systematic scoping review, Primary health care* Correspondence: madlabana@ukzn.ac.za1School of Applied Human Sciences, Discipline of Psychology, University ofKwaZulu-Natal, Durban 4001, Republic of South AfricaFull list of author information is available at the end of the article The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, andreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication o/1.0/) applies to the data made available in this article, unless otherwise stated.
Madlabana et al. Systematic Reviews(2020) 9:40BackgroundGrowing health challenges have placed pressure onhealth management to monitor and evaluate human resource for health (HRH) in an effort to strengthen healthsystems response to evolving health challenges [1]. Onesuch challenge is chronic conditions. Chronic conditionspresent the largest public health challenge of the twentyfirst century [2]. It is projected that by 2020, heart disease, stroke, depression and cancer will be the greatestcontributors of non-communicable diseases (NCDs),with mental disorders accounting for 60% of total mortality in the world. The number of people that requiredaily health care is rapidly growing, and it is projectedthat NCDs will continue to increase at a higher rate inlower-socio economic groups [2]. This has created aneed for NCDs surveillance, prevention and control [3].If not managed appropriately, chronic multiple NCDswill become the most expensive problem faced by healthcare systems globally [3]. This has resulted in the needfor the re-organisation of health care systems to caterfor chronic conditions, with people-centred care identified as the optimal approach to cater for multimorbidchronic conditions [4]. Noticeably, the ability of a country to strengthen its health system in order to meet itshealth goals depends largely on its human capital [5].The six core components or ‘building blocks’ of theWorld Health Organization (WHO)’s analytical framework of health systems includes the health workforce asthe people responsible for organising and deliveringquality health services [6, 7]. Quality health care refersto services that consistently deliver care that improvesor maintains health, is valued and trusted by recipientsand is responsive to changing population needs [5, 6],with people-centred services identified as central to thisendeavour globally given the changing disease profile towards chronic multimorbidity (see Table 1 for definitionof quality care). In order to achieve the above, the healthworkforce must possess the knowledge, skills, motivationand preparedness to engage in actions with the primaryintent to improve the provision of quality health servicesfor people-centred services. Therefore, it is of vitalimportance that health workers are motivated andsupported with the relevant capacities, thereby ensuringthat they significantly contribute to attaining healthobjectives set nationally and globally [6, 7]. One of thekey human resource (HR) processes used to facilitatetraining and motivation of any workforce is a performance management (PM) system.PM is described as a continuous process to identify,measure and improve the performance of individuals,teams and organisation, which involves aligning performance activities with the strategic goals of the organisation [7]. An important component of a PM system isperformance appraisal (PA). PA refers to the formalPage 2 of 9process of assessing performance at work. PA is alsosometimes referred to as performance review [9].Accordingly, PA is a necessary component of PMsystems. Some researchers argue that due to previousresearch not distinguishing between these two concepts,these terms are generally used interchangeably [9, 10].This study will do the same.Accordingly, PM systems primarily serve three broadfunctions:i.Strategically, PM systems aim to achieve thestrategic objectives of the organisation, which isachieved by linking the organisation’s goals withindividual performance goals [11].ii. Administratively, PM provides essential informationto help managers take important decisionsregarding salary increments, promotions andrewards [12].iii. The developmental function is facilitated through theprovision of feedback on evaluated performance.Through the feedback mechanism, remedial actionand steps to improve performance should bediscussed. This presents an opportunity for managersto coach employees and aid improvement inperformance on an ongoing basis [13].In order to re-configure health care systems to supportpeople-centred care for chronic multimorbid conditions,there is a need to initially identify methods and practicesthat promote effective PM that can be harnessed to thisend [14]. Methods refer to standard processes and procedures used by a PM system (this is usually prescribedby policy). Practices refer to the formal and informalapplication or execution of ideas, beliefs and methods.Such re-configured systems require a focus on training,motivation and readiness of health professionals who areat the forefront of facilitating changes in health care bestpractices, such as nursing staff who constitute the largestsector of health workers across the globe [15] (see Table1 for definitions of PM methods and practices). As animportant managerial tool, PM systems are a critical toolfor facilitating health system reforms as they determineif health workers are working diligently, trained appropriately and adequately rewarded for providing qualityhealth care interventions in line with the health systemsreforms [16].Contribution to the fieldPM methods and practicesPM systems are generally housed as part of role ofhuman resource management (HRM), within the healthcare sector. The benefits of HRM practices to employeewell-being and improved health outcomes have becomea topical discussion among human resource practitioners
- ‘Safe: Delivering health care that minimizes risks and harm to serviceusers, including avoiding preventable injuries and reducing medicalerrors.- Effective: Providing services based on scientific knowledge and evidencebased guidelines.- Timely: Reducing delays in providing and receiving health care.- Efficient: Delivering health care in a manner that maximizes resource useand avoids waste.- Equitable: Delivering health care that does not differ in quality accordingto personal characteristics such as gender, race, ethnicity, geographicallocation or socioeconomic status.- People-centred: Providing care that takes into account the preferencesand aspirations of individual service users and the culture of their community.’ [8]For instance, a registered nurse must have acquired the necessary expertknowledge base to work in an environment that requires complexdecision-making and clinical competencies for expanded practice. Suchnurses can generally work independently in clinics and private practices asprimary health care providers.PM practices refer to actual application and use of a PM method, asopposed to theories relating to it.The WHO definition of quality of care is the extent to which health careservices provided to individuals and communities improve desired healthoutcomes. Therefore, in order to achieve ‘quality of care’, health care mustbe safe, effectively, timely, efficient, equitable and people-centred.Nurses for the purpose of this review refer to nurse practitioners/advancedpractice nurses (also referred to as registered nurses). The characteristics ofthis kind of nurse are shaped by the context and/or country that s/he iscredentialed to practice.The concept of performance management (for this review) refers to aprocess of monitoring, reviewing and appraising registered nurses’ workperformance over a certain period of time.Primary health care refers to health care provided in the community forpeople initialling a visit to a medical practitioner or clinic for advice/treatment.PM practicesQuality health care/quality of careAccording to the PCC framework: Thetargeted population for this review isnurses/nurse practitioners/registered nurses.Concept (s): Performance management/performance appraisal/performance reviewContext: Primary health care- The review is concerned with nurses that work in the primary health caresetting. These nurses work at clinics, community-based health care centres, general practices and home-based health services.- The purpose of this process is to ensure accountability; thus, it wouldassist nurse managers in administering incentives towards goodperformance (eg. a performance bonus) and identify gap in one’sperformance so to develop/improve one’s ability (training anddevelopment needs). The terms performance management, appraisal orreview are used to describe this process—the preferred term to use isbased on the context/country in which it is used.- The above- mentioned methods are known to be effective in providingperformance data; however, in practice, factors such as the users’ attitudetowards PM methods, training of rater and ratees as well as the provisionof constructive performance feedback may impact on the overall successof a PM system.- Conducting annual performance appraisals through 360 feedback, peerreviews, behaviourally anchored rating scales (BARS) and critical incidents.PM methods refer to the particular procedures, processes or tools used toconsolidate data on the performance of staff, in the case of this study,registered nurses.PM methodsExample (s)DefinitionConceptTable 1 Key concepts and definitionsMadlabana et al. Systematic Reviews(2020) 9:40Page 3 of 9
Madlabana et al. Systematic Reviews(2020) 9:40and health care systems researchers around the world[17]. However, the impact of PM systems in health caresettings has not received as much attention. While thenature of each health system and the use of HRM differdepending on national context, regardless of the context,it has become evident across national settings that HR iscrucial in terms of its impact on patient outcomes andhealth care expenditures [18]. In order to determinehow current health care delivery and reforms in healthcare systems may fully utilise HRM processes and systems such as a PM system to improve quality health carefor people-centred care and promote better health outcomes [19], there is a need to initially examine evidenceon PM methods and practices, as well as its consequences on the delivery of quality care among nursesin PHC settings.PM opportunities and challengesSome identified challenges include a world-wide shortage of nurses, health worker’s commitment and job satisfaction [8, 13–19]. These factors have an impact onpatient care and the provision of quality service delivery.Generally, there is a limited understanding of how a PMsystem impacts on managing health workers, more specifically nurses and how it may be used to improve caredelivery and ultimately patient outcomes. Researchersopine that the purpose of PM systems is to monitor employees’ performance, motivate staff through providingopportunities for skills development and improving morale through rewarding and incentivising good performance. Their argument is that a PM system is one of themost important components of HRM. It provides justifications for decisions regarding recruitment and selection, training and development needs of existingemployees and how to optimise the quality of work andefficiency within individual health care centres as well asthe health system in general [18]. Accordingly, a poorlyimplemented PM system can be detrimental to staffmorale, overall job satisfaction and result in high staffturnover rates [20, 21]. The extent to which this hasbeen investigated in health care settings is not clear.Some experts have varying opinions and approaches toPM systems that may add to HRM outcomes and qualityof care [22]. Consequently, there is a need to reviewwhat is available on this topic for the purpose of creatinga greater understanding of PM systems, as well as toidentify knowledge gaps and providing recommendations on how future research may fill these gaps.The aim of this scoping review was to systematicallymap the available evidence on the PM of nurses in PHCsettings in order to enhance our understanding of therole of PM systems in improving ‘quality of care’, so asto understand how PM systems need to be strengthenedfor managing performance in PHC settings thatPage 4 of 9encourages improving quality people-centred care andimprove patients’ outcomes. This review offers a broadoverview of managing the performance of nurses working at various PHC settings. In addition, it provides ananalysis of international methods and practices used tomanage nurses. From these methods, it is possible toidentify best practices for suitable PM approaches.The review of primary research has gained popularity, as evidence-based practices gain recognition as abenchmark for care and primary research sourcescontinue to grow [23]. A scoping review is consideredas a relatively new method for reviewing literature,with the first such framework published in 2005. Thismethod of literature review is an advantage forsynthesising research evidence and mapping existingliterature in a given field in terms of its prevalenceand key features. Hence, it is also referred to as a‘mapping’ review [23, 24].MethodologySystematic scoping reviewWe will conduct a systematic scoping review of grey andpeer-reviewed literature on PM and its influence onquality of care among nurses in PHC settings. Thereview will be guided by the Arksey and O’Malley’s scoping review framework [25], which outlines the followingsteps: Stage 1. Identifying the research questionStage 2. Identifying relevant studiesStage 3. Study selectionStage 4. Charting the dataStage 5. Collating, summarising and reporting theresultsThe recommendations of Levac et al. (2010) will beused to improve the transparency of each step pertainingto the conduct of the systematic scoping review [26].Stage 1: Identifying the research questionThe central research question of the study is as follows:What is the existing evidence on the influence ofPM methods and practices on quality of care amongnurses in PHC?The sub-research questions are as follows:i.What are the common challenges and opportunitiesreported on various PM methods and practices?ii. What are the key gaps in literature on thecontribution of effective PM on quality of careamong nurses in PHC settings?
Madlabana et al. Systematic Reviews(2020) 9:40The study will use the broad population, concept andcontext (PCC) framework recommended by the JoannaBriggs Institute for Scoping Reviews [27, 28]. The designof the search strategy will be underpinned by a keyinclusion criteria (see Table 2).The PCC framework to determine the research questions is illustrated in Fig. 1.Stage 2: Identifying relevant studiesWe will identify relevant studies by conducting a comprehensive search on the following electronic databases:Academic Search Complete, PsycARTICLES. PsycINFO,Cumulative Index to Nursing and Applied HealthLiterature (CINAHL), Medline, Cochrane Library andPubMed. Literature will include published peer-reviewedjournal articles with primary studies which have a transparent empirical base utilising qualitative, quantitativeand mixed method research design and grey literatureaddressing the research questions.To achieve a comprehensive search, websites such asthe WHO and governmental websites will be used togather policies and guidelines on PM for the respectivehealth care sectors. Databases such as Google Scholar,Union Catalogue of Theses and Dissertations (UCTD)via SABINET Online and WorldCat Dissertations andTheses via OCLO will also be used to find relevantliterature.A hand search through the main published texts usedin PM systems and its outcomes will also be conducted.In addition, articles will be searched through the ‘citedby’ search as well as citations included in the referencelists of included articles. The search terms will includeNurse OR Nurse Practitioners OR Registered NurseAND, Performance Management OR PerformanceAppraisal OR Performance Review OR PerformanceManagement and Appraisal Systems AND PrimaryHealth Care or Clinics. This search strategy was pilotedto check the suitability of selected electronic databasesand key words (see Table 2).Stage 3: Study selectionFollowing the keyword search, relevant citations must beselected through title, abstract and full-text screening.The study selection process involves the elimination ofstudies that do not address the main research question.Developing an inclusion and exclusion criteria at theoutset of the study ensures there are clear guidelinesPage 5 of 9enforced, so each researcher is consistent in decisionmaking on the relevance for each citation [25]. An inclusion and exclusion criteria reduce the risk of bias in thereview, thereby minimising the risk of error and promoting credibility of the findings.In Table 3, information is provided about the inclusionand exclusion criteria that will be adhered to.An Endnote library will be created for the aforementioned review. The
Such nurses can generally work independently in clinics and private practices as primary health care providers. Concept (s): Performance management/ performance appraisal/performance review The concept of performance management (for this review) refers to a process of monitoring, reviewing and appraising registered nurses ’ work
Our survey tool queried on 18 management practices grouped into 4 primary dimensions: standardizing care (“Lean”, 6 practices), performance monitoring (5 practices), targets (3 practices), and employee incentives (4 practices). Table 1 provides a brief description of these 4 groupings and 18 practices.
ITIL 4 has shifted from step-by-step processes to holistic "practices" that incorporate culture, business goals, and stakeholders. The 34 practices are broadly categorized into general management practices, service management practices, and technical management practices. The ITIL management practices General Service Technical
Unethical Management Practices Final Employee Commitment Final Pearson Correlation Unethical Management Practices 1.000 0.443 Employee commitment final 0.443 1.000 Sig. (1-tailed) Unethical Management Practices. 0.00 0.000 Employee commitment final 0.000 0.0 N Unethical Management Practices 188 188 Employee Commitment final 188 188
SYMANTEC VISION 2014 Agenda NBU 7.6 Best Practices : Optimizing Performance 2 1 NetBackup Architecture & Scalability 2 NetBackup 5230 Appliance Scalability 3 NetBackup Performance Tuning Best Practices 4 NetBackup Performance Testing Best Practices 5 NetBackup 7.6 MSDP Performance Enhancements 6 NetBackup 7.6 Appliance Use Cases
Switch and Zoning Best Practices 28-30 2. IP SAN Best Practices 30-32 3. RAID Group Best Practices 32-34 4. HBA Tuning 34-38 5. Hot Sparing Best Practices 38-39 6. Optimizing Cache 39 7. Vault Drive Best Practices 40 8. Virtual Provisioning Best Practices 40-43 9. Drive
1. Agile methods are undisciplined and not measurable. 2. Agile methods have no project management. 3. Agile methods apply only to software development. 4. Agile methods have no documentation. 5. Agile methods have no requirements. 6. Agile methods only work with small colocated teams.-7. Agile methods do not include planning. 8.
psychology. Performance appraisal is a process within the overall system of performance management. Performance-management system has three objectives: i) to address poor performance; ii) to sustain good performance; and iii) to improve performance.
Ratio 104 121 143 165 195 231 273 319 377 473 559 649 731 841 1003 1247 1479 1849 2065 2537 3045 3481 4437 5133 6177 7569 50 Hz 60 Hz 13.9 12.0 10.1 8.79 7.44 6.28 5.31 4.55 3.85 3.07 2.59 2.23 1.98 1.72 1.45 1.16 0.98 0.754 0.702 0.572 0.476 0.417 0.327 0.282 0.235 0.192
