SELF EVALUATIONPEER EVALUATION

PATIENT SATISFACTION

UTILIZATION REVIEW&

APPLICATION TO NURSING SERVICE

EVALUATIONThe term evaluation is derived from the word ‘valoir’ which means ‘to be worth’.

Evaluation is the process of judging the value or worth of an individuals achievements or characteristics.

Evaluation is a decision making process that leads to suggestions for actions to improve participants’ effectiveness and program efficiency.

SELF EVALUATION

Self evaluation is defined as judging the quality of one’s work, based on evidence and explicit criteria, for the purpose of doing better work in the future.

It is one of the best method of performance appraisal, if it can systematically introduce. Self evaluation is the way in which an individual views himself.

PURPOSES OF SELF EVALUATION

To encourage continuing self-evaluation and reflection and to promote an ongoing, innovative approach.

To encourage individual professional growth in areas of interest to the employee

To improve morale and motivation by treating the employee as a professional in charge of his or her own professional growth.

CONTD…….To encourage collegiality and

discussion about practices among peers in an organization

To support employees as they experiment with approaches that will move them to higher levels of performance

BENEFITS OF SELF EVALUATION

Increased confidence in their own learning, in trying out new ideas, in changing their practice and in their power to make a difference.

Enthusiasm for collaborative working, despite initial anxieties about being observed and receiving feedback

Improved team-work and greater flexibility in their use of their skills

Increased awareness of new techniques and greater insight into thinking

Enhanced planning skills to ensure more effective task management

TOOLS FOR SELF EVALUATION

Staff annual professional review procedures

Peer support◦ Coaching◦ Joint preparation of materials◦ Planning◦ Team building

Observation can involve experts, can be informal or formal procedures. Feedback from such observation is very valuable.

Audit checklist

PEER EVALUATION

Peer review/Evaluation is a process by which employees of the same rank, profession and setting evaluate one another’s job performance against accepted standards.

O’ Loughlin and

Kaulbach

METHODS OF PEER EVALUATION

Direct observationVideotaping Evaluation of course materials

Analysis of portfolios

PROCESS OF PEER REVIEW

I. Establish a policy requiring peer reviews

II. Establish criteria for peer evaluationsIII. Procedure for conducting peer

evaluations

o Faculty chosen to conduct peer evaluations shall be tenured and hold on academic rank higher than that of the faculty member being evaluated

o A written report, addressing the criteria, shall be prepared and signed by the evaluator

CONTD……..o The department shall archive the

written evaluations for use in future evaluations

o One copy of the peer evaluation shall be placed in the permanent personnel file of the person being evaluated

o All reports of peer evaluations shall be included in the tenure file, and are to be carefully reviewed at the department

PATIENT SATISFACTION

“Patient satisfaction is defined as a health care recipients reaction to salient aspects of the context, process, and result of their service experience.”

- Pascoe (1983)

“Patient satisfaction is defined as the extent of the resemblance between the expected quality of care and the actual received care.”

- Scarding (1994)

NEED FOR EVALUATING PATIENT SATISFACTION

Data about patient satisfaction equips nurses with useful information about the structure, process and outcome of nursing care

It is a requirement for therapeutic treatment and is equivalent to self therapy. Satisfied patients help themselves get healed faster because they are more willing to comply with treatment and adhere to instructions of health care providers, and thus have a shorter recovery time.

METHODS OF MONITORING PATIENT SATISFACTION

Medical auditQuality assurance committee reviews

Indices of nursing performances

Judgemental method

COMPONENTS OF EVALUATION OF PATIENT SATISFACTION

Evaluation of the programs and activities of various departments including outpatient care, inpatient care, overall health education activities of the hospital

Evaluation of the various resources available in the hospital for effective health care

Evaluation of effectiveness of hospital personnel including medical, paramedical, nursing as well as non-medical employees of the hospital.

Services are relevant to the needs of the population it serves.

  ULITILISATION REVIEW

The utilisation review program includes determining appropriate hospital length of stay and necessary treatments for various illnesses and conditions and reviewing patient medical records on admission and at intervals during hospitalisation to ensure that the patient receives appropriate care.

AIMS AND OBJECTIVES

The main aim is to curb the exploding health care costs with conservative use of hospitalisation and expensive diagnostic and treatment procedures.

They work in liaison with a business organisation to provide healthcare services to the organisation’s employees at discounted rates.

Cost containment to limit each patient’s diagnostic and treatment measures to the fewest, least expensive procedures that will relieve patient symptoms, avert costly complications, and return the patient to fullest possible function in the shortest time possible.

UTILISATION REVIEW NURSEA utilization review nurse is a RN who reviews

individual medical cases to confirm that they are getting the most appropriate care.

They can work for insurance companies, determining whether or not care should be approved in specific situations, and they can also work in hospitals.

Members of this profession do need to possess compassion, but they also need to be able to review situations dispassionately to make decisions which are fair, even if they may be uncomfortable.

At a hospital, a utilization review nurse examines patient cases if the hospital feels that a patient may not be receiving the appropriate treatment.

CONTD……. In an insurance company, the utilization

review nurse inspects claims to determine whether or not they should be paid.

The nurse weighs the patient's situation against the policy held by the patient, the standards of the insurance company, and the costs which may be involved in treatment.

To work in this field, it is usually necessary to hold a current nursing license, and to have experience in the field.

APPLICATION TO NURSING SERVICES

NEED FOR EVALUATION According to WHO, Evaluation of Health

services, is the systematic process of determining the extent to which an action or sets of actions were successful in the achievement of predetermined objectives. It involves measurement of adequacy, efficacy, effectiveness and efficiency of the service being evaluated. It renders possible the reallocation of priorities, changes in the assessment of needs, the planning and implementation of care and the management of resources.

ASPECTS OF EVALUATON

Patient OutcomesEvaluation of the Competence of the worker

Evaluation of ResourcesRecording and Classification Systems

Purposes of EvaluationClarify and define objectives.Facilitate the improvement programme.Determine participants progress

towards the achievement of the goals of the programme.

Facilitates the maintenance of strength and elimination of weakness on the part of participants.

Motive the participants.Provide sense of accomplishments

(psychological security) for the participants and consumer.

CONTD….Develop more reliable and valid

instruments for measurement.Determine the overall value (eg:

cost, efficiency) of undertaking for both participants and consumer immediately over long period.

Establish and maintain standards to meet legal, professional and academic credentials.

TYPES OF EVALUATION Summative evaluation: It evaluates the

progress towards an established outcomes. The summative evaluations focus on the achievements or lack of achievement of outcomes. A Summative Evaluation, on the other hand, looks at more than one learner's performance to see how well a group did.

Formative evaluation: It analyzes the response to a specific intervention. Formative evaluations look at the particular pieces of the action plan and the relative importance to the whole. It is therefore tend to focus on the process of carrying out the action plan.

MODEL OF EVALUATION PROCESS

Observing

Measuring

Programme actions Information

Describing Relevance

Relatedness

Analysing Accountability

Monitoring

Development

Synthesizing Validity of goods

Worth of actions

Recommending Evaluation Support& Constraints

Principles of Performance Evaluation

Assess performance in relation to behaviorally stated work goals.

Observe a representative sample of employees total work activities .

Compare supervisors evaluation with employees self evaluation.

Cite specific examples of satisfactory and unsatisfactory performance

CONTD……Indicate which job areas have highest priority for improvement.

Evaluation conference should be held in good atmosphere.

The purpose of evaluation is to improve work performance and job satisfaction.

Tools of Performance Appraisal

Trait rating scales (TRS)Job dimension scales(JDS)Behaviorally anchored rating

scales (BARS)ChecklistsEssaysSelf appraisals.Management by objectives.Peer review-performance

carried out by peers.

Evaluation as a function of Nursing Management :

Fayol defined as “verifying whether everything occurs in conformity with the plan adopted, the instructions issued and principles established. It has for its object to point out weakness and error in order to rectify them and prevent recurrence”.

Urwick defines controlling or evaluating as “seeing that everything is being carried out in accordance with the plan which has been adopted, the orders which have been given and the principles which have been laid down.

Controlling /Evaluating Techniques

Nursing RoundsNursing Operating InstructionsGantt Charts Critical Control Points and

MilestonesProgram Evaluation and Review

Technique (PERT)BenchmarkingMaster Control PlanEvidence-Based Management

Eg: Gannt chart

Eg: PERT

Eg: Benchmarking