PERFORMANCE MANAGEMENT


SKILL BUILDER 3.1


1.      The job selected in this exercise is that of a receptionist in a medical clinic. Identified are a number of situational items for the possible system causes that are specific to the work setting of a medical clinic:


        4Failure to become knowledgeable about the internal organization of medical records in the clinic                4Lack of knowledge of medical terminology and medical records procedure                4Poor ability to communicate orally with the nurses, doctors, telephone callers and clinic patients                4Poor work coordination with the nurses, nursing assistants and doctors employed in the clinic                4Lack of an efficient system for keeping medical records                4Poor ventilation and lighting and uncomfortable seats in the reception area                4Lack of leadership and supervisory training to develop initiative, decisiveness and such other skills                4Inadequate information about clinic standing operating procedures concerning procedures for scheduling, rescheduling, canceling patient appointments, providing information, recording and filing information in patient charts, various medical test procedures.                4Failure to receive inadequate training regarding transcription of a variety of doctor’s orders on various charts and in-patient records, charting of medical data (for example temperature, blood pressure and respiration) completing and routing requests for patient activities and treatment procedures, obtaining, entering, and filing results of laboratory, X-ray, EKGs, and other procedures in patient’s records, among other basic miscellaneous support duties associated with patient care and treatment.

2.      The list of possible system causes generated above should be used as indicators of performance on which performance appraisal should be partially based. As there are factors that are beyond the immediate reach of the receptionist (for example, the poor physical conditions of the reception area), the list should not be the primary basis for performance evaluation. Specifically for diagnostic purposes, the list might be used as the guide with which to base subsequent actions from. For instance, knowledge that there are poor physical conditions in the reception area could pave way for the clinic administration to do something about the situation. Another, poor work coordination among the medical receptionist, nurses, nursing assistants and doctors employed in the clinic indicates that there might be a communication problem in the organizational midst. Therefore measures could be taken to remedy the situation for the betterment of the clinic as a whole.


3.      The use of the above list could affect the actor significantly because it could either improve or worsen the present circumstances, depending on how the participants to the system would react to the changes that will be more likely implemented in the light of such identification of system causes. The observer might be impacted by way of the end-results, whether positive or negative, which will be brought about by the use of the list.


4.      It would be important to view the possible impact of system factors as a continuum from inhibiting to facilitating in order to be more receptive of possible organizational changes or work systems associated with the achievement of a high performance system. There is a need of the understanding that such effects of the system factors could be viewed in a different light, given the right orientation and a large amount of willingness on the part of the participants to the system.


SKILL BUILDER 3.2


1.      Attribution is a three- stage process that involves: (1) the observation of the behavior of the subject; (2) determination if the observed behavior is deliberate or otherwise; and (3) attribution of the observed behavior to internal (controlled) or external (uncontrolled) causes[1]. Focus is on the two internal attributions, namely the ability and the effort, which affect the outcome of performance. The ability cause of performance is a relatively internal and stable factor over which the individual does not exercise much direct control while the effort cause is an internal and unstable factor over which the person can exercise a great deal of control[2]. The success of the individual’s own performance and the failure of the performance of others generally would lead to ability and effort attribution. This is due to peoples’ tendency to adapt a self-serving attribution, meaning it is a general perception that it is one’s merit and the others’ fault. Internal attributions can also be a result of the degree of consistency to which the actor performs the same behavior toward an object on different occasions, the degree of distinctiveness to which the actor performs different behaviors with different objects and the degree of consensus to which other actors perform the same behavior with the same object[3].


2.      Questions which can be asked are:


4Do I like the person or not? There are only two possible answers: yes or no. If so, attributing the performance outcome to the ability of the observed is more likely in the case of success, or if not, attribution would be to some other causes apart from ability. Causal inference which would support the positive answer would be that the person worked hard enough to have achieved a successful performance. On the other hand, the causal inference which would support the negative response would be that the success is a mere product of pure luck or coincidence.


4Is the person highly motivated or not? As with the first question, this question also has two probable answers: yes or no. If the observed is highly motivated, he will approach rather than avoid the task related to succeeding. The inference would be that if the highly motivated subject succeeds, it is mainly due to his ability to carry out the task, which he is confident of. Otherwise, or if the person is not highly motivated, the observed will avoid the task as much as possible, in the belief that his ability would not suffice to help in the attainment of a successful performance outcome.


4Is the performance within the spectrum of his strengths? If so, then it can be inferred that the performance problem is largely due to some other cause, because if it was within his capacity, there would have been a successful outcome in the first place. If not, then the causal inference which could support it would be that there was a problem in relating the performance to what he can and cannot do.


3.      a. The abilities that might be important for the effective and efficient performance of the medical receptionist job are: (1) multitasking ability; (2) critical thinking ability; (3) ability to remain calm; (4) ability to follow instruction with a minimum amount of supervision; (5) proficient record keeping ability; (6) ability to communicate effectively; and (7) selective attention ability or the ability to concentrate.


b. The above list of abilities could serve as the standard to which performance will be measured. If there is a finding that all of the abilities are possessed by the receptionist, then there is a good indicator that a high performance management is being carried out. However, if this is not the case, performance problems could then be traced back to the inadequacy or lack of such abilities needed to perform the medical receptionist’s duties and responsibilities.


4.      a. The efforts to: (1) do as much task in as little time; (2) help in activities within the medical clinic outside the work description; (3) maintain a harmonious relationship with coworkers and patients; (4) know the other concerns of coworkers and patients to which the receptionist might be of help; and (5) make the patients as comfortable as possible. There are basically five types of motivation (achievement, affiliation, competence, power and attitude). Performance management naturally focuses on the achievement motivation where the pursuance and attainment of goals is main driver in order to succeed. The identification of these types of motivation will be helpful in the diagnosis process in that through knowing them, the system will be able to apply the motivation which will push the system participants into becoming a high performing group.


      b. It is important to distinguish between intrinsic and extrinsic efforts because a number of findings have shown that there a paradox between intrinsic and extrinsic motivators in that intrinsic motivation is far stronger a motivator than extrinsic motivation, yet external motivation can easily act to displace intrinsic motivation. With the differentiation, the system will be able to handle the participants effectively through the knowledge of what type of motivation drives them more.


5.      Effort is a combination of internal person factor and external system factor. There is the need for the individual to source his inspiration in doing better from within himself, but the outside environment, the individual being a part of it,  also affects how much or how little effort he exerts in the performance of the particular duty he has at hand. In that light, if the performance diagnosis show that there is low effort, there may be the initial need to assess the internal and external factors which affect the effort exerted by the subject, then from there identify the measures imperative for bringing up the level of effort brought into the work performed.


SKILL BUILDER 3.3


1.      The structure for keeping a record of performance observations for a medical receptionist on the absolute performance appraisal technique where the observer will have to use written, absolute standards. Reviews are not based upon relative standing of the employee in a specific work group. The most common absolute style, which utilizes very general personal characteristics as a basis for evaluating the employee, will be used. The system would observe past performance as a standard for observation with the intention of tying in concrete examples from the past to motivate in the future. Observations will be made annually and the major headings to be found there will include, among other things, problem-solving, teamwork/cooperation, customer relations, leadership/supervision, communication and resource management. The performance observations will be organized by observation period, as it has, as mentioned, the intention of tying in concrete examples from the past to motivate in the future.


3.   The form worked well in all the aspects of observation. There is no need to change the structure of the form, as it adequately provided for all the information essential to monitoring and evaluating the performance of the medical receptionist. There is a need to increase the frequency of the observation though, from annually to twice a year, as it might be relatively easier to compare data from closer periods of time. Also, it will be more accurate and more up-to-date in that way.


SKILL BUILDER 3.4


1.      The same medical receptionist work is chosen for this activity. The major tasks that an analysis of the receptionist’s job uncovered are the following:


4Receives and screens telephone calls.


                  4Receives patients to the clinic, interviewing patients for treatment and confirms patient eligibility.

4Maintains patient logs (results of laboratory, X-ray, EKGs, and other procedures in patient’s records) and organizes all clinic files for easier filing and retrieval.


4Charting of medical data (for example temperature, blood pressure and respiration.


4Transcription of a variety of doctor’s orders on various charts and in-patient records.


4Completing and routing requests for patient activities and treatment procedures.


2.      I. PROBLEM SOLVING


a.      Flexibility, adaptability and decisiveness are exercised appropriately 4 -


b.      Assists coworkers in medical treatment when called for 4+


c.      Applies standard rules, procedures or operations to resolve routine problems 4+


d.      Independently carries out routine tasks 4 +


e.      Takes initiative in selecting and implementing appropriate procedures 4 -


                  II. TEAMWORK/COOPERATION


a.      Personal and organizational interactions exhibit and foster cooperation and teamwork 4 +


b.      Works with others to accomplish routine tasks 4 +


c.      Contributes ideas on routine procedures 4 -


d.      Regularly completes tasks in support of team goals 4 +


                  III. CUSTOMER RELATIONS


a.      Personal and organizational interactions enhance customer relations and actively promote rapport with customers  4+


b.      Assists customer support activities4 +


c.      Meets routine customer needs 4+


d.      Interacts with customers on routine issues within specific guidelines 4+


               IV. LEADERSHIP/SUPERVISION


a.      Takes initiative in accomplishing assigned tasks4 -


b.      Asks for assistance as appropriate4-


c.      Seeks and takes advantage of developmental opportunities4 -


               V. COMMUNICATION


a.       Communications are clear, concise, and at appropriate level4+


b.       Communicates routine task/status results as required4+


c.       Writes timely and accurate draft documentation4+


d.       Explains status/results of assigned tasks4+


               VI. RESOURCE MANAGEMENT


a.      Resources are utilized effectively to accomplish tasks 4+


b.      Uses assigned resources to accomplish tasks4+


c.      Plans individual and assigned resources to accomplish tasks4+


3.      There is a significant lack of leadership ability and supervision in the pattern of observed performance levels of the medical receptionist. It is evident that the employee lacks the leadership abilities which would otherwise let the individual perform the job responsibilities with as much confidence as possible. The social aspect of the job appeared easier to accomplish than those involving decision-making and such other activities requiring leadership skills.


SKILL BUILDER 3.5


1.      The following are the situation-specific system factors operating in the medical receptionist work situation :


4Knowledge about the internal organization of medical records in the clinic 4Ability to communicate orally with the nurses, doctors, telephone callers and clinic patients 4Coordination of work with the nurses, nursing assistants and doctors employed in the clinic 4An efficient system for keeping medical records 4Leadership and supervisory training to develop initiative, decisiveness and such other skills 4Adequate information about clinic standing operating procedures concerning procedures for scheduling, rescheduling, canceling patient appointments, providing information, recording and filing information in patient charts, various medical test procedures. 4Adequate training regarding transcription of a variety of doctor’s orders on various charts and in-patient records, charting of medical data (for example temperature, blood pressure and respiration) completing and routing requests for patient activities and treatment procedures, obtaining, entering, and filing results of laboratory, X-ray, EKGs, and other procedures in patient’s records, among other basic miscellaneous support duties associated with patient care and treatment.

2.      The performance observations show that all the list of situation-specific factors applies. There were instances in where performance difficulties were caused by a system factor. For instance, the lack of leadership and supervisory training has contributed to the receptionist’s difficulty in handling situations where initiative, decisiveness and like leadership and supervisory skills are called for. On the other hand, excellent social performance is facilitated by the receptionist’s ability to communicate with everyone in the clinic.


3.      The abilities important for performance in the medical clinic environment are as follows: (1) multitasking ability; (2) critical thinking ability; (3) ability to remain calm; (4) ability to follow instruction with a minimum amount of supervision; (5) proficient record keeping ability; (6) ability to communicate effectively; and (7) selective attention ability or the ability to concentrate. Motivations needed on the other hand involve a combination of extrinsic and extrinsic factors to bring out an attitude conducive to high performance on the job.


4.       There are no places where a different interpretation could be drawn as all the observation ties up with one another and is consistent of the performance level of the observed medical receptionist.




[1] From Human Motivation by Bernard Weiner (1980), Publisher: Lawrence Erlbaum Associates, Hillsdale, New Jersey.


[2] From The Psychology of Interpersonal Relations by Fritz Heider (1958), Publisher: Wiley, New York.


[3] From Attribution Theory in Social Psychology by Harold Kelley, Publisher: University of Nebraska Press, Lincoln, Nebraska.


 




Credit:ivythesis.typepad.com


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