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Contents Terms of reference. Page 3 1. Introduction. Page 4 2. Performance. Page 5 2.1. 2.2. 2.3. 2.4. Definition of Task Performance. Evaluation of Edith’s Task Performance. Definition of Contextual Performance. Evaluation of Edith’s Contextual Performance. Definition of Declarative Knowledge and Evaluation of Edith’s Declarative Knowledge. 3.2. Definition of Procedural Knowledge and Evaluation of Edith’s Procedural Knowledge. 4. The Traits Approach. Page 9 4.1. 4.2. The Behavioural Approach. The Results Approach.

3. Job Knowledge. Page 7 3.1.

5. Definition of Motivation and Evaluation of Edith’s Motivation. Page 11 6. People Management and Planning and Allocating Work Activities. Page 12 7. Conclusion. 8. Bibliography. 9. Appendices.

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Terms of Reference. This report will identify a range of performance problems in the St Jessica’s Urban Medical Center Emergency Room case study and suggests solutions to improve performance management, analyse techniques used for planning and allocating work activities to improve performance.

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1. Introduction. This report will examine the theory of performance management and identify performance and behavioural issues in the St Jessica’s Urban Medical Center Emergency Room case study. It will analyse task and contextual performance and declarative and procedural knowledge and identify approaches that could be used by the management team to measure and improve performance including the traits, behavioural and results approaches. It will explain the benefits of effective performance management with reference to theory and evaluate techniques for planning and allocation of work activities to improve performance.

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2. Performance. It is essential for any successful organisation to employ people that perform to a satisfactory level. That level is determined by the goals of the business and all employees must have a job description that sets out required expectations. It is vital that employees possess the skills, knowledge and abilities required of them for the business to achieve its goals. Performance must be reviewed to identify problems that could impact on the output of the organisation. When performance problems are identified steps must be taken to resolve them to ensure continued success of the business.

2.1.

Task Performance.

Task performance is based on the required tasks as set out in the job description. Efficient task performance is essential as failure to carry out tasks that are required to produce a product or deliver a service will damage the business. Task performance is guided by the knowledge, skills and abilities that are required to fulfil each job role. (organisationdevelopment, 2013). Evaluation of Edith’s Task Performance.

2.2.

Edith’s task performance was good, on Lucy’s arrival Edith carried out the required tests asking relevant questions regarding medical history, medication and current ailments. This information was recorded correctly. When Lucy returned from x-ray Edith liaised with the doctor and explained that the x-ray was clear. One failure of Edith’s task performance occurred after the doctor had issued Lucy’s discharge notes, the writing on the yellow copy was too light. When Lucy mentioned this, Edith wrote over the top in her own words making parts of it illegible which could result in litigation for the hospital.

2.3.

Contextual Performance.

Contextual performance is the individuals performance or behaviour that compliments the task behaviours while supporting the psychological, business and social environment. (Jeffrey. A, et al, 2000). Contextual behaviour is not related to tasks

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listed in a job description but may be related to skills and abilities. As contextual performance often involves performing over and above what is required from a job role, skills such as active listening, communication, service orientation and problem sensitivity are all related to contextual performance. Evaluation of Edith’s Contextual Performance.

2.4.

Edith’s contextual performance was poor throughout the case study. When Lucy returned from the restroom and advised Edith that the floor needed cleaning Edith responded by saying “I’m not housekeeping” and walked off. It may not have been Edith’s job to actually clean the restrooms however she could have politely advised Lucy that she would raise the issue with housekeeping. When Lucy asked to take her belongings to x-ray Edith said “Oh, all right. I’ll get you a bag”, Edith could have been less abrupt. On her return from x-ray after Lucy’s husband arrived and advised Edith that Lucy had some questions, Edith rolled her eyes and sighed loudly, this was bad mannered and un-necessary. This was also the case when Lucy asked what was going to happen next when Edith responded with her hands on her hips. After Lucy asked for a glass of water Edith shrugged her shoulders, and when she reviewed the discharge notes she was speaking rapidly, Lucy advised Edith that parts of the text were un-readable and Edith took the paper back quickly, amended it, handed it back and walked away. Before leaving Lucy again raised the housekeeping issue, when Edith responded she simply said “What?”. Edith put in minimal effort to help Lucy and was impolite. By simply being more pleasant Edith’s contextual performance could have improved and would have made Lucy’s visit more bearable however Edith did carry out her tasks as specified in the registered nurse job description.

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3. Job Knowledge. To carry out any job effectively an employee must have a detailed knowledge of their job. They must know exactly what is expected of them and have detailed knowledge of how to carry out the job including any policies and procedures that need to be followed. The definition of the application of job knowledge is described by yorku below, “Demonstrates an understanding of knowledge specific to a technical, professional, or administrative field of work through the application of related procedures, principles, theories or concepts. The ability to update job knowledge and effectively utilize available resources and technology.” (yorku, n.d.) The areas of knowledge required by Edith are listed as medicine, psychology, customer and personal service and English language. These can be broken down further in to declarative and procedural knowledge. Definition of Declarative Knowledge and Evaluation of Edith’s Declarative Knowledge. Declarative knowledge is the knowledge of “what” rather than “how” and is also referred to as the knowledge of facts as described below “Declarative knowledge is a broad category that includes facts, concepts, and the relationships between concepts that lead to an integrated conceptual understanding of a domain of knowledge.” (Schraw, 2009) Edith’s declarative knowledge was adequate, Edith would have required a detailed declarative knowledge of the areas involved in her initial examination of Lucy, she took her blood pressure and would need to know what results would be acceptable in order to advise the doctor. She asked Lucy about her medical history, medication and current pain which Edith would have required extensive declarative knowledge to fully assess Lucy and ensure the correct information was updated in Lucy’s medical record. Definition of Procedural Knowledge and Evaluation of Edith’s Procedural Knowledge.

3.1.

3.2.

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Procedural knowledge is the knowledge of “how” rather than “what” and refers to the knowledge we possess to actually carry out tasks. Procedural knowledge is a knowledge that manifests itself in doing something and is reflected in manual and cognitive or mental skills. People think, reason, dance, play musical instruments, ride bicycles and read other people’s faces and moods. Procedural knowledge is a knowledge of how to do something or to know the steps of a task or procedure. (Cortada & Woods, 2000) Edith’s procedural knowledge was mixed, when Lucy arrived Edith knew the procedure to follow when checking Lucy’s blood pressure, temperature and updating her notes. Edith knew that no liquids were allowed to be consumed if there was a possible requirement for surgery when Lucy asked for a drink of water. There were also occasions where Edith seemed to be lacking in procedural knowledge. When Lucy asked to take her belongings with her to x-ray Edith responded that they could be left in the room and seemed unaware that the hospital is not responsible for personal items. When Lucy returned from x-ray she asked Edith what was going to happen next and Edith did not know that Lucy had already been to x-ray, although this could be explained by the fact that Edith was extremely busy.

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4. The Traits Approach to Assessing Performance. The traits approach is related to the person rather than the job and assumes that leaders are born and not taught. One problem with this approach is that the list of traits is long as it relates to people rather than the job. This would make it difficult to relate any particular traits to successful performance management and as it relates to the individual it is not something that can be taught. There have been many studies into common traits of leadership that have failed to identify common personality, physical or mental characteristics of different good or successful leaders. (Mullins, 2002) Despite its limitations the traits approach could be effective if the emergency room was to be re-structured as attention could be paid to the selection of people rather than training.

4.1.

The Behavioural Approach to Assessing Performance.

The behavioural approach is related to the job rather than the person and identifies behaviours that increase organisational productivity. Research in the 1940’s identified two areas of leadership behaviour, a concern for people and a concern for the task. Concern for people increases levels of trust and communication between managers and employees. Concern for the task involves directing people to carry out tasks in the most efficient way to achieve production targets. The research discovered that employee turnover rates were lowest and employee satisfaction highest under managers who had high consideration for people. (Hannagan, 2002). Unlike the traits approach behaviours can be taught as they are job related. As the job tasks and work activities are essential requirements of a registered nurse all training should have been carried out. Edith’s task performance was good so training in those areas would have no benefit.

4.2.

The results Approach to Assessing Performance.

The results approach measures the results of a particular process or person. In order to achieve an effective results approach the processes must be measureable, there are many ways to do this, one being the SMART method (See Appendix 3) which

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ensures that goals are realistic and achievable. One benefit of the results approach is that it measures the outcome of tasks rather than the traits or behaviours of the person therefore this approach can be effective for everyone. Another benefit is that it identifies specific areas that require training. In the case study attention could be paid to Edith’s contextual performance and look at work activities such as assisting and caring for others which requires Edith to provide personal assistance and emotional support.

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5. Definition of Motivation and Evaluation of Edith’s Motivation. Motivation causes people to act in certain ways, if a person is motivated at work they are likely to put in maximum effort to complete a task to the best of their ability. If a person is not motivated, their work performance is likely to be below the standard expected of them. Motivation can be broken down into three parts as explained by Rollinson (2002, p197) Motivation is essentially an exploratory concept used to explain why a person behaves in a certain way. It describes three components of behaviour that have an impact on performance. Direction of behaviour, which is greatly influenced by what a person most desires to do. Intensity of behaviour, which roughly equates to how hard the individual strives to go in that direction. Persistence, which consists of the individual’s willingness to stay with the direction when obstacles are encountered. There are several theories of motivation such as those devised by Maslow and Herzberg. Herzberg’s theory of motivation (See Appendix 1) could be used to analyse Edith’s motivation. Herzberg’s theory consists of two parts, hygiene factors and motivational factors. Herzberg maintained that hygiene factors are necessary conditions of successful motivation. (Handy, 1999) Three of the hygiene factors as described by Herzberg would have an effect on Edith’s levels of motivation. Firstly the quality of supervision, throughout the case study there is no mention of Edith having to report to a supervisor. Secondly relations with others, Edith’s relationship with Lucy was poor and communication was brief and impolite, however it is not part of Edith’s job description to build relationships with patients. Finally the working conditions on the day of the case study were strained due to the City Central Hospital refusing ambulances. This had caused the emergency room to be busier than normal and had a negative effect on working conditions. As the hygiene factors are considered necessary for employees to be truly motivated it is highly unlikely that Edith was motivated. There are instances in the case study where Edith showed a lack of motivation for example when Lucy complained that the restroom was dirty, Edith could have easily arranged for housekeeping to attend to it.

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6. People Management and Planning and Allocating Work Activities.

Effective people management is essential for organisations to optimise their performance as defined by CIPD (2013.a) A process which contributes to the effective management of individuals and teams in order to achieve high levels of organisational performance. A good performance management system will set out the goals of the organisation and ensures that all employees know what is expected of them and that they have the necessary skills and resources to carry out their roles effectively. In order to be effective, performance management needs a structure to support it, this needs to have a reasonable amount of flexibility and to operate as a continuous cycle. (CIPD, 2013.b). The introduction of a performance management model such as the one illustrated below (See Appendix 2) could be used in many organisations. Stage one focusses on creating a strategic management model where the roles and responsibilities of all employees are made clear. Based on their level of authority managers and employees can set up and follow action plans in their own areas (Andre, 2007.a). By restructuring managers can be put in place to ensure effective planning of work activities and allocation of staff. Stage two involves creating a strategic reporting model to monitor performance and act on issues that may arise as described below. “The art of management is not to know everything that is happening in an organization, but to know what the key issues of the business are, keep track of them, and take action on them.” (Andre, 2007.b) Monitoring performance can be done by analysing performance by using key performance indicators to measure areas such as quality, costs and production times. Regular employee performance appraisals highlight problems and identify areas for improvement. An alternative to a traditional appraisal is three sixty degree feedback which takes performance information from a range of sources as explained below, “360 feedback is a performance appraisal system that gathers feedback on an individual from a number of sources, typically including colleagues, direct reports and customers. Its supporters claim that this gives managers and individual’s better information about skills and performance, as well as working

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relationships, compared with more traditional appraisal arrangements based on line managers’ assessment.” (CIPD, 2013) Stage three involves designing a performance driven behavioural model as explained by Andre, “This stage consists of establishing the characteristics of performance-driven behaviour; aligning personal objectives with strategic objectives; and linking performance management with competency management.” (Andre, 2007.c) By implementing an effective behavioural model organisations can use information learned in stage two to resolve issues and identify training or disciplinary requirements that may be needed to link the personal objectives to the strategic objectives of the business.

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7. Conclusion This report has identified that Edith had good task performance and adequate declarative knowledge however her procedural knowledge was mixed and contextual performance was poor. Edith was not motivated and had performance issues which needed to be addressed. The traits approach could be used when recruiting and restructuring however would be no good to resolve Edith’s problems. The behavioural approach could potentially work but would have to be used throughout the department and involve all nursing staff. The results approach would be most effective as it can be used to resolve problems in specific areas rather than attempting to change a person’s behaviour. The report has highlighted the need for a performance management system to be used in all organisations to ensure effective people management and that ideally it needs to be cyclical to ensure the development of people is continuous.

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8. Bibliography/References

Cortada, J & Woods, J. (2000) The knowledge management yearbook 2000 – 2001. Oxford, Butterworth-Heinemann, p16. –

Foster,

C.

(2013) our

Organisational

psychology

individual

differences: from:

challenging

assumptions.

[Internet]

Available

http://organisationdevelopment.org/tag/contextual-performance/ [Accessed 26th April 2014]

Handy, C. (1999) Understanding organisations. Harmondsworth, Penguin Books Limited.

Jeffrey, A. (2000) Contextual performance and teamwork: Implications for staffing. Research in personnel and human resources management. [Internet] 19 (1) pp.53-90. Available from: http://www.emeraldinsight.com/books.htm?chapterid=1781293 [Accessed 27th April 2014]

http://www.yorku.ca/hr/documents/Competency_Inventory.pdf (yorku, n.d.)

Loeb, J.M. (2004) The current state of performance management in healthcare. International journal for quality in healthcare. [Internet] 16 (1) p.5. Available from: http://intqhc.oxfordjournals.org/content/16/suppl_1/i5.full.pdf 2014] [Accessed 5th May

Rollinson, D. (2002) Organisational behaviour and analysis an integrated approach. 2nd Ed. Harlow, Pearson Education Limited, p197.

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http://www.emeraldinsight.com/journals.htm?articleid=1610496 (Andre, 2007)

Schraw,

G.

(2009)

Knowledge

[Internet].

Available

from:

http://www.education.com/reference/article/knowledge/ [Accessed 26th April 2014]

9. Appendices.

Figure 1 Herzbergs Theory of Motivation

Figure 2, Strategic Performance Management Development Cycle

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Figure 3, SMART Objectives

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