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PubMedDate not supplied

Assessing the legality of performance appraisals.

Performance appraisals have recently become the focus of legal scrutiny. Because the appraisal process may lead to salary adjustments, promotions, opportunities for development, discipline, or even termination, issues such as fairness and discrimination are raised. This paper discusses specific constitutional and statutory laws that prohibit discrimination in performance appraisals. In addition, specific rulings from select court cases illuminate key legal defense factors in performance appraisal. Questions are posed to help identify weaknesses in a laboratory's performance appraisal system.

Employee Performance Appraisal↗
PubMedDate not supplied

Best practices for assessing competence and performance of the behavioral health workforce.

The need for mechanisms to assess the competence and performance of the behavioral health workforce has received increasing attention. This article reviews strategies used in general medicine and other disciplines for assessing trainees and practitioners. The possibilities and limitations of various approaches are reviewed, and the implications for behavioral health are addressed. A conceptual model of competence is presented, and practical applications of this model are reviewed. Finally, guidelines are proposed for building competency assessment protocols for behavioral health.

Behavioral Medicine↗
PubMed2002

Computer technology applications in industrial and organizational psychology.

This article reviews computer applications developed and utilized by industrial-organizational (I-O) psychologists, both in practice and in research. A primary emphasis is on applications developed for Internet usage, because this "network of networks" changes the way I-O psychologists work. The review focuses on traditional and emerging topics in I-O psychology. The first topic involves information technology applications in measurement, defined broadly across levels of analysis (persons, groups, organizations) and domains (abilities, personality, attitudes). Discussion then focuses on individual learning at work, both in formal training and in coping with continual automation of work. A section on job analysis follows, illustrating the role of computers and the Internet in studying jobs. Shifting focus to the group level of analysis, we briefly review how information technology is being used to understand and support cooperative work. Finally, special emphasis is given to the emerging "third discipline" in I-O psychology research-computational modeling of behavioral events in organizations. Throughout this review, themes of innovation and dissemination underlie a continuum between research and practice. The review concludes by setting a framework for I-O psychology in a computerized and networked world.

Computer-Assisted Instruction↗
PubMed1995

Role of clinical evaluation in academic medical centers: results of a national survey.

BACKGROUND: It is widely acknowledged that academic medical centers (AMCs) must be committed to appropriate resource use and to the clinical evaluation research needed to accomplish this goal. The authors report the results of a national survey and series of site visits to further elucidate the role of centralized mechanisms for evaluating clinical practice, called clinical evaluation units (CEUs). A CEU is characterized by a separate operating unit with a physician director on at least a half-time basis complemented by data analysts, information system specialists, or other technical staff. METHOD: In April 1993, the authors mailed a survey instrument to the 60 hospitals that were members of the University Hospital Consortium (UHC) and to 28 non-UHC teaching hospitals. After four follow-up mailings and telephone reminders, a 69% response rate (61 responses) was achieved. The survey instrument highlighted areas such as the environment in which the hospitals operated, the structure and organization of clinical evaluation, the process of how these activities were carried out, and the outcomes from the CEUs. RESULTS: Twenty-two respondents had centralized mechanisms that met the authors' definition of a CEU. Support for most CEUs came from hospital administrations and not from medical school deans. An alternative structure emerged from the analysis: 18 respondents indicated that they did not have CEUs but that clinical evaluation activities were integrated into the medical staff hierarchy and dispersed throughout departments that reported to a physician executive. CONCLUSION: The discipline of clinical evaluation is in its infancy in teaching institutions. Many AMCs do not have a coordinated program of clinical evaluation; others are just starting. Clinical evaluation must become integrated into medical education and hospital operations to serve as one aspect of academic medicine's response to health care reform.

Academic Medical Centers↗
PubMed1985

Role conflicts in nursing and allied health: a comparison of professional and organizational commitment.

Role compatibility and conflict between organizational and professional commitment for nurses, high school teachers, college faculty, and social workers have been the focus of several studies over the past two decades. The typical view has been that the professional employee must choose between the profession and the employing organization, since the values of each conflict. Primarily, studies have shown a basic incompatibility between professionals and organizations: the professional is seen as responding to authority based on expertise, while the organization is characterized by authority based on hierarchical position. Since a study of this type has not been conducted in allied health specifically, the purpose of this study was to examine whether bureaucratic and professional role concepts conflict with the allied health professional. Recent graduates and graduates with two years of employment experience representing nursing and four allied health disciplines at one institution were surveyed. Results of the study indicated that the respondents were able to maintain a high degree of professional commitment without perceiving undue conflict from the demands of the organization. Based on the findings, allied health educators are encouraged to examine the curriculum to ensure graduates are prepared for the realities of employment as well as committed to their respective professions.

Adult↗
PubMed1981

A data-based examination of selection-bias in the evaluation of a job-based alcoholism program.

We describe the strategy of constructive confrontation present in most job-based alcoholism programs, and conclude that it is compatible with the major concepts and practices of discipline in the workplace. We review past evaluation studies of these programs, noting the rather remarkable positive outcomes often reported. We then review reasons for both accepting and rejecting these unusual findings. One of the major biases that could produce the favorable findings-selectivity bias-is then examined, using both field data and record data from a large national corporation. Samples from records in the review period 1964 through 1977 generated 377 case histories. The study also used field interviews in the same corporation in a national sample of 19 locations. We interviewed supervisors who had experienced an employee in the alcoholism program (A sample = 154) and a sample of all other supervisors (B sample = 351) who described a nonalcoholic problem employee and how he/she had been managed. The remainder of the report focuses upon two possible sources of selection bias: suspected but not referred cases in the field data, and incomplete, "lost," cases in the record data. In both instances, the selectivity seemed to be quite minimal, insufficient to damage the conclusion that the program intervention had produced significant positive changes in job performance.

Alcoholism↗
PubMedDate not supplied

How hardwired is human behavior?

Time and time again managers have tried to eliminate hierarchies, politics, and interorganizational rivalry--but to no avail. Why? Evolutionary psychologists would say that they are working against nature--emotional and behavioral "hardwiring" that is the legacy of our Stone Age ancestors. In this evolutionary psychology primer for executives, Nigel Nicholson explores many of the Science's central tenets. Of course, evolutionary psychology is still an emerging discipline, and its strong connection with the theory of natural selection has sparked significant controversy. But, as Nicholson suggests, evolutionary psychology is now well established enough that its insights into human instinct will prove illuminating to anyone seeking to understand why people act the way they do in organizational settings. Take gossip. According to evolutionary psychology, our Stone Age ancestors needed this skill to survive the socially unpredictable conditions of the Savannah Plain. Thus, over time, the propensity to gossip became part of our mental programming. Executives trying to eradicate gossip at work might as well try to change their employees' musical tastes. Better to put one's energy into making sure the "rumor mill" avoids dishonesty or unkindness as much as possible. Evolutionary psychology also explores the dynamics of the human group. Clans on the Savannah Plain, for example, appear to have had no more than 150 members. The message for managers? People will likely be most effective in small organizational units. As every executive knows, it pays to be an insightful student of human nature. Evolutionary psychology adds another important chapter to consider.

Biological Evolution↗
PubMed1986

The practice of pharmacy in England.

The practice of pharmacy in England is described. Community pharmacies have a contract with the Department of Health and Social Security to fill National Health Service prescriptions. A large proportion of the general public obtain their prescriptions free. Funding for the health service comes from taxes and automatic contributions from employers and employees. Aspects of hospital pharmacy practice and salaries are discussed, e.g., a junior pharmacist may expect to earn between $9000 and $12,000. There is very little unit-dose dispensing, and many hospitals are unable to provide 24-hour services. Hospital pharmacies function with fewer pharmacists than their U.S. counterparts, utilizing larger numbers of technicians. Clinical pharmacy practice centers around drug monitoring (ward pharmacy). Pharmacokinetic services are provided in a few places. Master of science degrees in clinical pharmacy are available. However, the future of clinical pharmacy practice in England depends on staffing levels and competition between and acceptance from other health disciplines.

Community Pharmacy Services↗
PubMed2003

Organization of nursing care as a determinant of job satisfaction among hospital nurses.

This study examined the relationship between methods of organizing nursing and employee satisfaction. Data were collected from 26 ward sisters and 568 nurses working in 26 bed wards with different stabilized nursing models. Methods of organizing nursing, such as primary, modular, team and functional nursing, were associated with job satisfaction. However, this association involved only certain features of these organizational models and specific components of satisfaction. After the effects of demographic and ward characteristics were partialed out, hierarchical regression analyses showed that patient-focused work allocation, opportunity to write nursing notes and accountability for patient care contributed to nurses' satisfaction with supervision and personal growth. The relationships of duty rota and liaison with other discipline to job satisfaction were weaker or non-existing.

Attitude of Health Personnel↗
PubMedDate not supplied

The return map: tracking product teams.

With a new product, time is now more valuable than money. The costs of conceiving and designing a product are less important to its ultimate success than timeliness to market. One of the most important ways to speed up product development is through interfunctional teamwork. The "Return Map," developed at Hewlett-Packard, provides a way for people from different functions to triangulate on the product development process as a whole. It graphically represents the contributions of all team members to the moment when a project breaks even. It forces the team to estimate and re-estimate the time it will take to perform critical tasks, so that products can get out fast. It subjects the team to the only discipline that works, namely, self-discipline. The map is, in effect, a graph representing time and money, where the time line is divided into three phases: investigation, development, and manufacturing and sales. Meanwhile, costs are plotted against time--as are revenues when they are realized after manufacturing release. Within these points of reference, four novel metrics emerge: Break-Even-Time, Time-to-Market, Break-Even-After-Release, and the Return Factor. All metrics are estimated at the beginning of a project to determine its feasibility, then they are tracked carefully while the project evolves to determine its success. Missed forecasts are inevitable, but managers who punish employees for missing their marks will only encourage them to estimate conservatively, thus building slack into a system meant to eliminate slack. Estimates are a team responsibility, and deviations provide valuable information that spurs continuous investigation and improvement.

Cost-Benefit Analysis↗
PubMed2005

Execution without excuses. Interview by Thomas A. Stewart and Louise O'Brien.

The success of Dell--it provides extraordinary rewards to shareholders, it can turn on a dime, and it has demonstrated impeccable timing in entering new markets--is based on more than its famous business model. High expectations and disciplined, consistent execution are embedded in the company's DNA. "We don't tolerate businesses that don't make money," founder Michael Dell tells HBR. "We used to hear all sorts of excuses for why a business didn't make money, but to us they all sounded like 'The dog ate my homework.' We just don't accept that." In order to double its revenues in a five-year period, the company had to adapt its execution-obsessed culture to new demands. In fact, Michael Dell and CEO Kevin Rollins realized they had a crisis on their hands."We had a very visible group of employees who'd gotten rich from stock options," Rollins says. "You can't build a great company on employees who say, 'If you pay me enough, I'll stay.'" Dell and Rollins knew they had to reignite the spirit of the company. They implemented an employee survey, whose results led to the creation of the Winning Culture initiative, now a top operating priority at Dell. They also defined the Soul of Dell: Focus on the customer, be open and direct in communications, be a good global citizen, have fun in winning. It turned outto be a huge motivator. And they increased the focus on developing people within the company. "We've changed as individuals and as an organization," Rollins says. "We want the world to see not just a great financial record and operational performance but a great company. We want to have leaders that other companies covet. We want a culture that makes people stick around for reasons other than money."

Commerce↗
PubMed1983

Overview of occupational epidemiology: issues/dilemmas.

Occupational epidemiology is an essential discipline in the practice of occupational medicine. Many issues/dilemmas that plague the success of the practice in this field such as absence of complete and integrated company records, loss-to-follow-up, use of records for a purpose other than that for which they were intended, variations in exposure with calendar time and arising from within plant movement, the broad ranges of response with their resultant advantages and disadvantages, the magnitude of the probability of response and its relationship to the size of the study population, have been discussed. The current approach to solving these many issues/dilemmas is by the development of health information systems that prospectively gather employee medical surveillance data, tracking of employee work history and exposure monitoring data and have the built-in ability to relate these data for health studies. Care needs to be taken to assure that comparable data are gathered at different geographic sites within a company and possibly across an industry so that small but real probabilities of response can be identified.

Body Burden↗
PubMed1987

Performance management: an essential program for poison centers.

Medico-legal liability and cost effectiveness mandate that poison information specialist performance be optimal. To maximize performance we developed and implemented a performance management program to achieve the objectives of high quality assurance in a cost-effective environment. The program can objectively assess, monitor, develop, discipline and financially compensate poison center staff. The performance standards, jointly developed by the staff and management, are the cornerstone of the program. They serve as a means of measuring and quantifying poison information specialist performance based upon compliance with responsibilities outlined in the standards. Our program enables the poison information specialist to optimize performance and also be cognizant of suboptimal work. Each staff person works with management to develop personal goals, objectives, and a plan for professional growth. Performance standards facilitate good management by improving communication, providing objective feedback, making orientation consistent, and providing an objective basis for promotion and compensation. They also provide an objective basis for dismissing unsatisfactory employees when performance is consistently suboptimal. Since personnel salaries account for 80% of a poison center's budget, effective performance management is essential.

Employee Performance Appraisal↗
PubMed1997

Staff knowledge, attitudes and practices in public sector primary care of diabetes in Cape Town.

OBJECTIVE: To audit staff knowledge, attitudes and practices in the interest of improved public sector primary care for diabetics. DESIGN: External audit using face-to-face, private, questionnaire-based interviews. SETTING: Twelve public sector ambulatory health centres in Cape Town. SUBJECTS: Non-specialist, principal staff members (N = 35)-12 doctors, 10 primary health care nurses (PHCNs), 7 registered nurses (RNs) and 6 staff nurses (SNs). RESULTS: Staff members were long-standing employees (mean-doctors 6 years, PHCNs 8 years, RNs 5 years, SNs 12 years). Few had post-basic training (doctors 25%, PHCNs 20%, RNs 26%, SNs 83%). Knowledge of chronic diabetic complications was adequate, e.g. diabetic eye disease was mentioned by 100% of staff. There were gaps in knowledge of pathophysiology and of signs and symptoms of diabetic emergencies, e.g. < 33% knew control of hypertension to be important in the prevention of diabetic nephropathy. Knowledge of appropriate care of patients with hypoglycaemia (94% mentioned glucose administration) was better than that of hyperglycaemia (69% mentioned intravenous fluids). Problems were reported in inter-staff communication within (approximately 50%) and between (approximately 75%) disciplines by doctors, PHCNs and RNs. Staff/patient communication problems were reported by approximately 75% of staff. Solutions suggested by staff included meetings between staff members and with management, in-service training programmes and appointment systems for patients. Despite logistic, organisational and communication-related problems, most staff enjoy and believe in the value of their work. CONCLUSIONS: This study reveals deficiencies in in-service training with consequent gaps in knowledge and practice. Recommendations that would lead to improved quality of care and increased staff and patient satisfaction have been given.

Attitude of Health Personnel↗
PubMed1984

Health beliefs and exercise habits in an employee fitness programme.

A prospective study examined the attitudes, practices and physical characteristics of adults who enrolled in and adhered to a workplace fitness programme. Questionnaires on health beliefs and exercise habits were completed by 409 participants in an employee fitness programme and by 374 randomly selected non-volunteering controls. All underwent initial aerobic testing, and 20 months later 263 of the original enrollees were re-evaluated. Among the males, concern for health and belief in the health value of exercise were significantly stronger among enrollees than in controls. A higher level of perceived health and realistic expectations of the programme characterized male enrollees who went on to higher levels of exercise. For women, perceived health and belief in exercise were stronger in initial participants, but there were no clear predictors of exercise adoption. Although attitudes towards exercise generally became more positive over the programme, low-level participants came to view exercise as less "fun" and more "discipline". People who are ready for change and believe in exercise may enter a fitness programme, but adherence is influenced by personal factors such as the perceived state of health and the acceptability of the specific exercise programme.

Attitude to Health↗
PubMed2002

Science for the common good.

A smile comes easily to the face of Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, as he encounters visitors to his offices at the Institute. He does not, however, allow himself to be distracted from his duties for longer than it takes to nod warmly. The sense of discipline and the determination and preparedness that were instilled in him through a Jesuit course of education are apparent. He is as direct and as clear spoken in person as you've seen him on television, speaking on innumerable occasions over the past two decades about the pathology and treatment of AIDS, and more recently, delineating the public health from the national security issues precipitated by the bioterrorist events of the past year. The three office assistants who occupy his reception area have been particularly taxed in the management of Fauci's schedule since 9/11; as they pause briefly from their work to share photographs of a friend's recent wedding, Fauci is there to admonish them, semi-good-naturally, as government employees, to return to their official duties. He has been meeting with high government officials and has been courted by the media for interviews regularly since the tragedies began. Given his high profile, it is easy to forget that Fauci is, foremost, a clinical immunobiologist and physician. His dedication to science is part of his commitment to public service, also a value instilled in him by the Jesuits. Fortunately for all of us, Fauci was pursuing this combination of interests--within the venue of bioterrorism--in his official capacity at the NIAID well before the general public had awaken to the threat.

Biomedical Research↗
PubMedDate not supplied

Leadership for psychiatrists.

OBJECTIVE: This article introduces the prospective leader to a set of questions and relevant leadership literature that aid in the process of deciding whether to accept a leadership position. METHOD: The author conducted a review of literature and discussion with leaders in psychiatry and other medical disciplines. RESULTS: The questions posed and leadership literature discussed provide a useful set of guidelines for potential leaders in deciding whether to accept or continue in a leadership position. CONCLUSIONS: Having access to mentoring, a clear description of "expected results," personal appreciation of leadership style, a description of available resources, a leadership vision in line with the institutional vision, and an appreciation of the necessary time commitments are fundamental in deciding whether to accept a leadership position.

Academic Medical Centers↗
PubMedDate not supplied

Creating market opportunities: innovation is the key.

If innovation is so easy and has such great rewards, then why is everyone not doing it? Many healthcare executives may say they just do not have the time. Some may say that the daily pressures and constant firefighting on the job sap their energy. Others may reason that they do not have the resources. These are all valid responses. However, innovation, especially our proposed evolutionary innovation, can start on a small scale and does not have to be the responsibility of one person. For example, 3M encourages employees to set aside a modest percentage of their time to explore new ideas and projects. In addition, some organizations (in and out of healthcare) have adopted "no meeting Fridays" to give staff a chance to reflect and challenge the status quo. An even simpler approach is to throw away the standard agenda for a scheduled meeting and use the time for an informal group-innovation discussion. There is a saying, "If you want things to stay the same, then something is going to have to change." The healthcare industry is changing and will continue to change, despite the best efforts on the contrary. Those who resist the tide of change should heed the parable of the boiled frog, which Peter Senge (1990), in his book The Fifth Discipline, identified as one of the many reasons for eliminating organizational learning disabilities. The lesson of the parable is simple: if you put a frog in boiling water, it will jump out; but if you put it in cold water and gradually turn up the heat, it will let itself be slowly boiled to death because it does not perceive any immediate danger. Are you aware of the gradual market threats to your organization, and are you willing to innovate before the threats reach the "boiling point"? I hope this series has introduced you to some concepts in strategic marketing. More importantly, I hope it has provided some marketing approaches that you can consider, pursue, and apply in your organization.

Diffusion of Innovation↗