Abu Dhabi Health Authority, also referred to HAAD (Health Authority – Abu Dhabi), aims to regulate health practices in Abu Dhabi. The HAAD official web page states that HAAD also has to ensure that proper, affordable and high-quality health care for all citizens of the Emirates region of Abu Dhabi. In order to achieve this, the organisation has to craft and design a suitable strategy, or strategies. The company policy generally arises from the company’s mission and vision statements. Apart from these, the company also needs performance management systems that allow the managers to evaluate their projects. This essay discusses the contribution of performance management systems to achieve the overall organisational goals.
The performance management systems normally remind the staff of the things they are supposed to value. The measures take note of the company values, mission statement, vision and strategy in order to make a scale for the evaluation.
Goel (2008) defines performance management systems as ways of measuring and evaluating the successes and failures of an organisation. There are numerous ways of evaluating a company and its projects. In many organisations, this task is left to the monitoring and evaluating department. However, it suffices to mention that each department can and should, be measured from time to time.
The first way in which performance measurement systems help attain company goals is through enhancing employee performance. As mentioned, there are numerous ways of evaluating performance. Harvard Business School Press (2009) asserts that employees often reward their employees in order to motivate them to perform better. Performance measurement systems allow the employees to find out which employee worked best, in order to rightfully reward the involved. In addition to this, ensuring that performance management systems work efficiently and without bias allows the company to know which employees are dragging their feet. In turn, important decisions on hiring and firing can be made. Performance measurement systems also motivate the employees to work better.
For instance, if a company introduces a performance measurement technique, the employees will be somewhat forced to improve their performance levels. In fact, as Attorney (2007) observes, many employees are of the opinion that performance appraisals are meant to determine the people who will be fired. To some extent, the employees are scared of losing their jobs, so they work better. The hard and improved performance level help the company achieve some of its goals.
In addition to this, performance measurement systems also help the company in restricting their projects. There are performance measures that aim at checking the projects that have been done, the ones that have not been done and how successful or unsuccessful these projects were. For example, HAAD has invested in programmes that create and increase awareness and acceptance of healthy living standards among the citizens of Abu Dhabi. Such programmes can be evaluated using a series of monitoring and evaluation surveys. HAAD (n.d.) can then decide which programmes can be extended and which ones cannot because of failed strategies.
This also allows the organisation to decide on future strategies for the same programmes. For example, if the programme is creating awareness in schools, then HAAD would have to come up with strategies on rolling out the programme. During evaluation, the company will be in an enlightened position to pick out strategies that worked, and remove those that did not work. This would help shape up their strategies for similar programmes in the future.
In the same vein, performance measurement systems help a company achieve its organisational goals by reminding the stakeholders of what why they are working. Northouse (2010) confirms that losing focus on what is on the line can make the employees and the stakeholders, in general, relax. They will then lower their performance levels, in turn reducing profits. HAAD might not be looking to make profits; however, for the organisation to succeed in its projects, it has to have some resources.
Performance management systems also allow the managers in HAAD to recognize some of the essential skills that their employees need. For example, in HAAD the employees have to be computer literate, patient records are recorded in digital formats; thus, anyone who is not computer literate will slow down the pace. The company can find such loopholes from performance management systems. Ray and Chakraborty (2014) argue that these systems also allow the employees to make better suggestions during meetings. For example, employees that feel they do not have sufficient training in one field can suggest a training session for all employees in that section. The only way the company will know the advantage of such training is through a performance appraisal
It suffices to mention that many performance management systems crop up from the company strategy. As mentioned, in order attain successful management in any company, managers have to ensure that their mission, vision and company strategy are aligned. For example, the HAAD mission statement is to ensure reliable excellence in healthcare for the community (HAAD, n.d.). Its vision is to have a comprehensive health care system accessible to all citizens in Abu Dhabi, driven by excellence through continuous improvement.
From the two statements, one can already conclude that the company strategy will involve ways of increasing accessibility of quality healthcare to the citizens. In turn, this points out the goals of the company. For example, one goal is to ensure that all citizens get access to affordable and high-quality health care. Therefore, everything else comes up together to ensure that the goal is realized. Monitoring and evaluating performance allows the company to know exactly where they are in terms of achieving their objectives. Additionally, it gives a clear indication of what needs to be done and what has to stop in order to achieve the set objectives and influence the company strategy.
In conclusion, performance management systems offer a company several ways of bettering their services and products, while giving a clear roadmap on how far the company has progressed. The importance of performance management systems cannot be overstated. Managers have used it in the hiring and firing of staff, while the process gives staff motivation. For example, employees know that performance appraisals lead to rewarding. Many of the employees become competitive and increase their performance levels in order to be rewarded. Moreover, the employees that are not performing well are shunned as they reduce company profits. Needless to say, no one wants to be avoided in the workplace due to fear of losing their job. Performance management systems also help companies achieve their goals by fusing the vision, mission and business strategy together. The unity of these three crucial components of any organisation influences the types of decisions made as they influence the end game.
References
Attorney, D. (2007). Performance appraisal handbook. Berkeley, CA: NOLO. Web.
Goel, D. (2008). Performance appraisal and compensation management: A Modern approach. New Delhi, India: PHI. Web.
HAAD (n.d.). About HAAD. Web.
Harvard Business School Press (2009). Performance appraisal: Expert solutions to everyday challenges. Boston, MA: Harvard Business School Publishing. Web.
Northouse, P. G. (2010). Leadership: Theory and practice. Thousand Oaks, CA: Sage Publications. Web.
Ray, N., & Chakraborty, K. (2014). Handbook of research on strategic business infrastructure development and contemporary issues in finance. Hershey, PA: IGI. Web.
The purpose of the paper is to describe the impact of adverse conditions on human physical performance and to apply the findings to the military environment with the focus on the effectiveness of training resistance to the chosen adverse condition. The subject under investigation is sleep deprivation because very often soldiers spend days without sleep that is why its influence is worth studying.
Sleep deprivation is a subject of much researches because nowadays people usually do not get enough sleep due to work schedules and a dynamic lifestyle. That is why it is necessary to know its possible outcomes. Daviaux, Mignardot, Cornu, and Deschamps (2014), for example, conducted research aimed at finding how total sleep deprivation affects the perception of action capabilities. They divided twenty-four participants, men and women of nearly the same age and physical indices, into two groups.
People from the first group stayed awake for 24 hours in the laboratory while the second one was the control group. The experimental task was to define the maximum height of stepping over the bar by adding 2.5 cm at a time. It had two parts: assessing one’s possibility to perform the task and actually doing it. The results have proved that sleep deprivation has a deleterious impact on assessing situations that might have dangerous outcomes and lead to inattentiveness (Daviaux et al., 2014).
One more similar research was carried out by Dąbrowski, Ziemba, Tomczak, and Mikulski (2012) for the purpose of investigating the effects of 36 hours without sleep combined with 20 hours of intermittent exercise. The authors have chosen eleven healthy men of nearly the same age, height, body mass, and body mass index. Measurements were made at the beginning of the experiment, after 24 and 36 hours. What is special about the study is that the participants were asked to stay active by doing moderate physical exercises.
The results have shown that long-lasting sleep deprivation if combined with physical activities, leads to a drop in heart rate, degradation of motion coordination, and shooting performance but does not influence handgrip sensitivity and psychomotor performance (Dąbrowski et al., 2012).
Studying human physical performance under the conditions of partial or long sleep deprivation is of extreme significance if adapted to the military environment because, in fact, these are the conditions soldiers live in during the times of warfare. The results of both types of research mentioned above are important as they demonstrate that not enough sleep can become the reason of thoughtless behavior as the ability to assess potential danger decreases. Moreover, less or no sleep leads to detraction and degradation of motion coordination that can have lethal outcomes in the case of shooting and/or overt acts of war.
However, soldiers can and should be trained to resist sleep deprivation because it is one way of making them more productive and the overall results of military missions positive. Together with that, it can help save people’s lives and thus guarantee that the armed forces are strong and can hold the front. The possible psychological costs of training such as changes in the mood with the shift to negativity and sleepiness (Mário & Teresa, 2013) are nothing as compared to the benefit of being alive and surviving in the military environment. What is more, when trained, soldiers feel less influence of sleep deprivation on attention and physical performance, unlike the ones who are not adapted.
References
Dąbrowski, J., Ziemba, A., Tomczak, A., & Mikulski, T. (2012). Physical performance of healthy men exposed to long exercise and sleep deprivation. Medicine Sportiva, 16(1), 6-11. Web.
Daviaux, Y., Mignardot, J. B., Cornu, C., & Deschamps, T. (2014). Effects of total sleep deprivation on the perception of action capabilities. Experimental Brain Research, 232(7), 2243-2253. Web.
Mário, C., & Teresa, P. (2013). Partial sleep deprivation in Portuguese Navy militaries. Sleep Medicine, 14(1), e197. Web.
Identify some of the challenges for the HR managers in the public healthcare sector
It is stated that the public health care sphere is growing, and healthcare institutions experience an acute shortage of qualified personnel. Therefore, some of the major problems for HR managers in the sector include maintaining the right quantity of qualified personnel, which incorporates both hiring and retention (Pizzi par. 3).
Another important question is keeping up with constantly advancing technology, which means not only purchasing new equipment, but training the staff to properly use it, and complying with continuously changing standards (Pizzi par. 6).
How would you ensure HPWS is in place in a hospital?
Introducing HPWS is a difficult task, for it requires changing relationships between the management and employees to give the employees more freedom and allow for more autonomous decision making. The difficulties come from the managers, for they tend to be conservative and are unwilling to provide the necessary autonomy; it is also difficult for them to resist the temptation to hire low-skilled workers to pay lower salaries (Tomer 18-19). Therefore, to establish HPWS in a hospital, it is necessary to work with the management and explain to them the principles of HPWS and the benefits they bring.
What activities, duties, and attributes would you include in the role of HR manager in a hospital?
By the fundamental principles of HPWS (Tomer 2), the following duties should be among those performed by HR managers of hospitals: 1) selecting and hiring highly professional personnel; 2) providing safe and healthy working environment; 3) supplying constant training for the employees; 4) evaluating performance and providing the staff with bonuses for outstanding performance; 5) organizing and maintaining a system for effective information sharing among the workers.
Case Study 2: The Perils of Downsizing
What are the external factors that are affecting the labor profile needed by the university?
According to the materials of the case, these external factors include:
some modifications that the international student visa regulations have undergone, as well as alterations which occurred in General Skilled Migration Program;
new Australian dollar exchange rates, which made studying in Australia more expensive for overseas learners;
a rise in competition between Australian universities and universities from other countries, such as the United Kingdom, the USA, and some Asian states;
a rise in the amount of violence towards people of different race or ethnicity;
changes in rules for university funding, which tied the number of places at a university to student demand;
alterations in the structure of students’ demand for various fields.
Factors 1-4 have decreased the total level of demand for places in Australian universities, factor 6 has reduced the students’ demand for places in some faculties, whereas factor 5 establishes strict limits for funding.
Identify possible ways that the HR planning function within the university could provide better information to university decision-makers
The human resource planners of the university should have predicted that the voluntary redundancy measure would lead to the loss of the top-performance personnel of the institution. Before introducing this measure, the probable outcomes should have been estimated. It appears obvious that if there has been a drop in demand for university places in some scientific field, there would not be many staff members related to this field to whom it would be easy to find new work, and that those who could do that would be among the best employees.
It is also important to note that human resources are among the most valuable resources for an educational institution. Therefore, alternatives to staff redundancies should have been considered.
Given the information in this case, what are the advantages and disadvantages of the downsizing of staff numbers at the university?
The main advantage of cutting the personnel numbers appears to be the decrease in the budget difficulties of the university. The disadvantages, on the other hand, include the loss of prominent scholars, reduced levels of productivity and work involvement of the staff, lower job satisfaction, etc. Considering these negative consequences, it is possible to assume that these redundancies will result in lower quality of teaching, a decrease in the university’s reputation, and, therefore, in the loss of even more students.
Case Study 3: Designing a recruitment program for the Western Australian Police (215 words left to write, 60 – questions)
Given the concerns of the auditor general, provide a suite of recommendations to improve the efficiency and effectiveness of the first stage of the WAP selection processes for new police members
In our opinion, it is important to review the current selection criteria and assess their timeliness. It is possible to benchmark these criteria to those of the other police departments of the country. It is also viable to improve both efficiency and effectiveness of the selection process by using modern technologies, e.g. by letting the applicants use computer-based tests rather than written ones.
What recruitment strategies would you recommend to increase the number of female recruits?
To increase the number of female recruits in the police, we would recommend considering the specific needs of women who enter the police force, and finding out what might especially attract them to this job. Among the obvious methods, it is possible to offer more career and promotional opportunities at all levels (for instance, by introducing some minimal quotas for women at different levels), provide women with better conditions of maternity leave, etc. Also, the possible prejudice against women among the male police members should be investigated; such prejudice might significantly discourage potential women candidates to work for the police. It also might prove useful to promote the image of a female police officer in the media, thus encouraging more women to join the organization.
What recruitment strategies would you recommend to increase the number of Indigenous recruits?
To increase the number of Indigenous recruits in the police, our recommendation would include researching what specific needs these people might have and offering them a way to satisfy those needs by serving in the police, as well. The image of the police that incorporates diversity as one of its fundamental principles would possibly increase the number of Indigenous people working for the organization. Better career opportunities for native people would also be helpful.
In the history of the United States, the period of the liberation of the American territories from the British Empires’ rule is one of the most decisive and notable ones. Indeed, the War of 1812 was a significant historical event that contributed to the United States as it is known today. The participation of renowned individuals and military specialists in this war was a pivotal factor that allowed for pursuing the mission of America of winning the war and obtaining independence from Great Britain. While the ultimate goal was complete liberation, the successes in separate battles served as stepping stones leading toward victory. One of such decisive battles was the Battle of New Orleans of 1815, in which General Andrew Jackson led a small American army against Great Britain’s significantly larger troops and won. The aftermath of this success contributed to the strengthening of the American positions in the war and signified the opportunities for signing a treaty on beneficial terms.
This paper is designed to analyze the performance of General Andrew Jackson as a commander of the Battle of New Orleans against his compliance with the principles of the Mission Command. In particular, the paper will focus on such principles as competence, mutual trust, commander’s intent, and disciplined initiatives. It is claimed that the professionalism and following of the principles of the Mission Command by General Andrew Jackson was a pivotal factor in achieving success in the Battle of New Orleans.
Principle of the Mission Command and their Importance in Andrew Jackson’s Performance in the Battle of New Orleans
When approaching important military tasks, leaders are expected to complete the missions and tasks in the most efficient manner allowing for minimal losses and maximized benefits. The Mission Command principles help leaders align their decision-making with the goals of their performance. In particular, “at its heart, the army’s approach to mission command is about applying the appropriate level of control so that, given the circumstances and information available, leaders make the best possible decision at the right level and at the right time.”1 Thus, following the seven core principles such as “competence, trust, shared understanding, mission orders, commander’s intent, disciplined initiative, and risk acceptance,” leaders execute their duties fully.2 For the purposes of analysis’ focus on Andrew Jackson’s strongest sides, this paper emphasizes four out of seven principles.
The Principle of Competence
The success of Andrew Jackson’s execution of the mission in the Battle of New Orleans largely depended on his competence in military affairs. The principle of competence implies the possession by the leader of the necessary knowledge, skills, and capabilities to cope with the challenges of warfare tactics in order to lead the troops and manage resources. Moreover, it deals with the ability of a military leader to facilitate available forces and weapons in a manner that gains a competitive advantage over the rival.3 Thus, the competence of a mission commander involves a multitude of skills ranging from critical thinking and analytical mindset to responsible decision-making based on experience.
Previous experience in conducting military tasks and effectively managing troops contributed to General Andrew Jackson’s understanding of the principles of the battlefield, tactics of proper army engagement, and the achievement of force use efficiency. In the battle taking place within the war before 1815, General Andrew Jackson successfully led his troops to planned victories. One of the instances is his command in the Battle of Horseshoe Bend on March 27, 1814, when the troops of the American army under the guidance of Andrew Jackson defeated the Creek tribe that collaborated with the British troops.4 This encounter allowed Andrew Jackson to practice his warfare skills and successfully accomplish the mission of the battle using his decisive approach to bold decision-making.
Indeed, with the intensification of Britain’s plans of invading New Orleans as the main port of America, the defense of the city was essential. Due to the clarity of his orders and the effectiveness of his planning of actions, his troops were capable of attacking the enemy before their planned invasion at the moment of rivals’ weakness.5 The leader was responsible for analyzing the positions of the opponents, their military capabilities, and weaknesses to coordinate his not numerous soldiers through the battle. As researchers state, Andrew Jackson’s campaign against the British during the Battle of New Orleans was a complicated and well-thought-through effort. Indeed, Hulver states the following:
“Southern and western militia made up a large portion of Jackson’s force, and many of these were free people of color; complex fortifications constructed over days by skilled engineers (not anachronistic cotton bales) and well placed heavy artillery manned by experienced Army and Navy artillerists, not the gumption of frontier marksman with long rifles, carried the day.”6
Indeed, the engagement of free men of color on the battlefield was a strategic decision that shaped the forces of America under General Andrew Jackson’s command. In such a manner, competence as a warfare leader was a ground-forming factor in Andrew Jackson’s success in the battle of New Orleans. It helped him integrate multiple determinants, such as rivals’ capacity and state, as well as the troops’ availability among the American people. Ultimately, the victorious Battle of New Orleans signified America’s path toward liberation from the British Empire.
The Principle of Mutual Trust
Another important principle of the Mission Command in Andrew Jackson’s execution of the mission in the Battle of New Orleans was the principle of mutual trust. Within the framework of mission command, trust is perceived as an element of relationships between a leader and the teams of colleagues or subordinates in which they share the same values based on the common experiences of productive work.7 According to research, it is required to allocate a substantial amount of “time, training, and deliberate efforts by commanders to build trust and confidence in subordinate leaders.”8 Thus, for a mission commander to cultivate trust in the subordinates and develop trust toward them, it is necessary to initiate training and preparation for the reliability of the actions of the team members.
In the case of General Andrew Jackson’s conduct in the Battle of New Orleans, the trust in the army was solid and mutual, which helped the troops act in a unified and organized manner with determination. Indeed, historians note that Andrew Jackson could create a trusting but strict atmosphere in which the motivation and the rules of behavior were clear but demanding.9 In such a manner, the soldiers were aware of what to expect and that their mission was competently overseen by a reliable leader. In particular, since Andrew Jackson engaged free black men in his troops, such a strategy was characterized by the cultivation of trust due to the unexpected and commonly resistant cooperation between white soldiers and freed people of color. It was pivotal to demonstrate a trustworthy position in the commander’s tactics when gathering forces from the militia, including the different demographics that required proper motivation to join the troops and believe in the success of the campaign.10 Thus, the enrollment, training, and preparation for the Battle of New Orleans were characterized by trust-building efforts that ultimately contributed to the event’s success.
The Principle of Commander’s Intent
Despite the importance of other principles of the mission command, the principle of the commander’s intent plays a pivotal role due to its ultimate influence on compliance with other principles. Indeed, with the appropriate direction of a leader’s intention, the overall strategy is more likely to be successful. According to research, command and control “empowers subordinate decision-making and decentralized execution, using mission orders to enable disciplined initiative in the accomplishment of the commander’s intent.”11 In such a manner, it is the intent of the leader that predetermines the large-scale motivation and small-scale decisions and actions of the team members within the context of a mission.
During the Battle of New Orleans, General Andrew Jackson’s intent was coherent with the overall purpose of the campaign, its operations, and particular tasks completed by the soldiers. Indeed, the leader was strongly motivated by the goal of defeating the British Army and maintaining American control over the territories of the city of New Orleans and its ports, in particular.12 Importantly, Jackson’s prioritization of proactive initiatives was based on his in-depth understanding of the mission and evaluation of the uneven distribution of power between the numerous British troops and limited American forces.
It is relevant to note that General Andrew Jackson’s strategic decision’s within the framework of the principle of commander’s intent reached far beyond mere troops coordination and assembling. Indeed, his infrastructure-related tactics and changes facilitated the resource delivery for New Orleans. According to research, “Jackson suggested that a road from division headquarters in Nashville could be run to New Orleans at little expense and that the road would greatly shorten the current land route.”13 He managed to analyze the landscapes, roads, infrastructure, and other important elements necessary to support the army and hinder the attack plans of the rivals. In such a manner, given the principle of the commander’s intent, the completion of the Battle of New Orleans was fast. It led to significantly fewer casualties on the American side in comparison with the numerous losses of the rival.
The Principle of Disciplined Initiatives
Finally, the accomplishment of any military mission is impossible without disciplined initiatives. Indeed, with proper structure and instruction characterized by demanding requirements and empowerment of subordinates for their completion, the army is capable of achieving missions efficiently.14 The commander is expected to execute their power of influence through discipline and engagement. According to Townsend, “the art of command is the exercise of leadership and decision-making to accomplish the mission on balance with the soldier’s welfare, morale, and discipline.”15 Indeed, discipline guarantees coordinated actions and efficiency, which is essential for successful mission completion.
The compliance with the principles of disciplined initiatives was decisive in the context of the Battle of New Orleans. Many soldiers working under the command of Andrew Jackson reported his strict and demanding management style, through which he necessitated responsibility and dedication from each team member.16 Indeed, through training and empowerment, as well as trust-building, Jackson managed to cultivate the individual responsibility of each soldier for the outcome of the battle. He emphasized the cost of alignment and organized actions being the victory against the British troops, which reinforced the troops’ motivation. Ultimately, the arrangement of discipline initiatives helped Andrew Jackson avoid ineffective movement and increased the army’s performance level to its full capacity despite its smaller size in comparison with the British Empire. Thus, the defeat of the British in the Battle of New Orleans allowed for securing America’s valuable port and contributed to the prompt signing of the treaty.
Conclusion
In summation, the analysis of General Andrew Jackson’s performance in the Battle of New Orleans has demonstrated the contribution of the commander to the success of the military operation. Firstly, the principle of competence was followed by the leader since he applied his knowledge and skills in order to organize his troops and plan the tactics of the battlefield that ultimately allowed for success. Secondly, the principle of mutual trust was essential in General Andrew Jackson’s performance since he managed to engage his troops through motivation and reliability of his expertise; the same goal of liberation and defeat of the British Empire was the common ground for mutual trust between the leader and soldiers. Thirdly, the principle of the commander’s intent was manifested through the articulation by Andrew Jackson of his aspirations in the war and his ideals in the Battle of New Orleans; the clarity of his intentions was motivating for his followers and informative in terms of his efficiency in decision-making. Finally, the principle of disciplined initiatives allowed for creating a strict but functional culture in the army and guiding soldiers with clarity and purpose.
Bibliography
Davis, William C. The Greatest Fury: The Battle of New Orleans and the Rebirth of America. Westminster: Penguin, 2019.
Hulver, Richard. “A Bloodless Victory: The Battle of New Orleans in History and Memory.” Civil War Book Review 20, no. 3 (2018): 1-4.
Townsend, Gen Stephen, Maj Gen Douglas Crissman, and Maj Kelly McCoy. “Reinvigorating the Army’s Approach to Mission Command.” Military Review 6 (2019): 4-9.
Wren, Dustin Mitchell. “Through the Wilderness: Andrew Jackson’s Military Road and the Settlement of the Southern Frontier.” Master’s Thesis, Missouri State University, 2021.
Footnotes
1 Townsend, Gen Stephen, et al., “Reinvigorating the Army’s Approach to Mission Command,” Military Review 6 (2019): 8.
2 Townsend, Gen Stephen, et al., “Reinvigorating the Army’s Approach to Mission Command,” Military Review 6 (2019): 7.
3 Townsend, Gen Stephen, et al., “Reinvigorating the Army’s Approach to Mission Command,” Military Review 6 (2019): 5-6.
4 Davis, William C., The Greatest Fury: The Battle of New Orleans and the Rebirth of America, Westminster: Penguin, 2019: 12.
5 Wren, Dustin Mitchell, “Through the Wilderness: Andrew Jackson’s Military Road and the Settlement of the Southern Frontier,” Master’s Thesis, Missouri State University, 2021: 2.
6 Hulver, Richard, “A Bloodless Victory: The Battle of New Orleans in History and Memory.” Civil War Book Review 20, no. 3 (2018): 1.
7 Townsend, Gen Stephen, et al., “Reinvigorating the Army’s Approach to Mission Command,” Military Review 6 (2019): 8.
8 Townsend, Gen Stephen, et al., “Reinvigorating the Army’s Approach to Mission Command,” Military Review 6 (2019): 8.
9 Davis, William C., The Greatest Fury: The Battle of New Orleans and the Rebirth of America, Westminster: Penguin, 2019: 88.
10 Wren, Dustin Mitchell, “Through the Wilderness: Andrew Jackson’s Military Road and the Settlement of the Southern Frontier,” Master’s Thesis, Missouri State University, 2021: 7.
11 Townsend, Gen Stephen, et al., “Reinvigorating the Army’s Approach to Mission Command,” Military Review 6 (2019): 4.
12 Davis, William C., The Greatest Fury: The Battle of New Orleans and the Rebirth of America, Westminster: Penguin, 2019: 109.
13 Wren, Dustin Mitchell, “Through the Wilderness: Andrew Jackson’s Military Road and the Settlement of the Southern Frontier,” Master’s Thesis, Missouri State University, 2021: 9.
14 Townsend, Gen Stephen, et al., “Reinvigorating the Army’s Approach to Mission Command,” Military Review 6 (2019): 6.
15 Townsend, Gen Stephen, et al., “Reinvigorating the Army’s Approach to Mission Command,” Military Review 6 (2019): 7.
16 Davis, William C., The Greatest Fury: The Battle of New Orleans and the Rebirth of America, Westminster: Penguin, 2019: 116-117.
Health is viewed as a motivating factor and is required in any organization that is considering success. Incorporating health and wellness into the organizational corporate culture is one of the most influential strategies for the promotion of more productivity of employees (Riedel et al., 2001).
It is also important when an organization is seeking to decrease the costs of healthcare (Weinstein et al., 1996). This strategy would place an organization at a level higher than that of its competitors and therefore stand out.
The wellness programs are meant to promote the employee’s health lifestyles. They also help to improve and maintain their health and wellbeing. The programs are useful in preventing (if not delaying) the onset of diseases (Pelletier, 1999). In so doing, the employee would be in a position to work effectively and the organization would benefit.
Ill health is a contributor to decrease in productivity as the employees spend more time seeking treatment than working (Goetzel et al., 2000). This may be in terms of increased absenteeism by the employees. Ill health also contributes to loss of morale in the working place and causes less productivity.
The health and wellness programs aim at assessing the employees’ health risks and provide interventions to the problems (Aldana and Pronk, 2001). This could be in the provision of health education that provides training on lifestyle management that is meant to decrease the risks of diseases and to improve outcomes. The main aim of the programs is to prevent the occurrence of disease.
They may also provide assistance to those workers with chronic diseases. This is through the provision of disease management interventions and other nurse-based decision support systems. Generally, health and wellness programs may be deemed useful in increasing the performance of employees due to the assurance of health and the motivation that comes with it.
Literature Review
Several studies have provided evidence to show the importance of workplace wellness programs. Many organizations have implemented the use of health and wellness strategies in order to realize many benefits. Some of the benefits include an increase in productivity, reduced absenteeism and a decrease in the use of health care benefits (Kessler et al., 2001).
Studies have also shown that the use of health and wellness programs at the workplace increases the morale and loyalty among the employees. Additional benefits of these programs include the reduction of incidences of injuries and long-term disabilities. These programs also help reduce the health care costs (Aldana, 2001).
Through research, organizations have been able to understand that many diseases can be prevented through the use of health and wellness programs. The preventable diseases have been believed to make up to 80 percent of the burden of diseases. This also accounts for about 90 percent of all health care costs (Anderson et al., 2000).
This has prompted many organizations to take advantage of this statistic by implementing health and wellness programs within the workplace. If the employees increase their physical activity and keep fit, they would have lower chances of contracting some common diseases and conditions. Consequently, the companies will need to spend less in covering for the health costs of these diseases.
Apart from this form of cost, companies can also reduce the incidences of absenteeism due to these preventable diseases. With perfect health, employees will be motivated to work more effectively as compared to those individuals suffering diseases.
The United States has been reported to have spent the most on health care as compared to all other industrialized nation worldwide. However, it is also considered the unhealthiest. This just shows the need for workplace wellness programs in the workplace. This would help reduce the need for health care costs since the health and wellness programs would reduce the risks for diseases.
The implementation of the health and wellness programs in an organization has been regarded as a potential high return on investment. This is because of the rise in health care costs that has translated to high expenditure in the event that employees are treated for diseases, most of which are preventable.
Employers get back a substantial amount of return in reduced health care costs as the individuals become more fit and healthy. This program also helps lower absenteeism costs since employees would not require being away from work while attending to their health issues.
Certain research studies have indicated significant relationships between certain health risk factors and the performance of employees. Aspects such as absenteeism have also been seen to have a moderate to high degree of association with the basal metabolic rate (BMI). Research also indicates that there is a relationship between the basal metabolic rate and various components of work performance.
In a certain research by Pronk and colleagues, the number of days spent away from work was used as a measure for absenteeism (Pronk et al., 1999). These were referred to as work-loss days. They concluded that absenteeism was significantly associated with severe obesity. These results corroborated other previous findings on the same.
However, there was a specific study that provided different results that showed gender disparity. In the particular study by Narbro and colleagues, the obese females showed a high level of absenteeism when compared to those who were not obese (Narbro et al., 1996).
When it came to the obese males, the situation was different. In fact, their level of absenteeism was less as compared to their non-obese counterparts. Research conducted by Tsai and Gilstrap (1997) also supported these findings.
Tucker and Friedman (1998) also conducted a similar study. They used the percentage body fat as a measure to categorize workers as obese, average or lean. The skinfold measurement was used in the categorization. They concluded that there was a significant relationship between absenteeism and the degree of skinfold. The measure of skinfold was taken to represent degree of adiposity.
In the study by Pronk and colleagues, a significant relationship between the basal metabolic rate and absenteeism was only found at the level where employees were severely obese. The severely obese category consisted of those individuals who had a BMI of 40 kg/m2 or above. There was no severe significant difference when it came to the obese category.
Where obesity did not have an impact on absenteeism, it caused a decrement on work performance. This was specifically as a result of issues associated with interpersonal relationships.
In order to measure the interpersonal relationships among employees, the researchers considered the degree to which an individual got along with the fellow employees. The results indicated a positive association between work performance decrement with obesity. However, this was not the case for other fitness variables.
The issues to do with interpersonal relationships among employees may be related to lack of motivation for employees to spend their time working. This situation worsens as obesity extends into severe obesity. This is probably because of the social stigma associated with this state.
It reduces the quality of peer interactions and increases the chances for absenteeism from work. Various studies have shown the existence of a relationship between obesity and certain characteristics of interpersonal relationships.
Studies have also shown a relationship between obesity and certain issues related with employment. For example, those individuals who were obese were discriminated against during employee selection and recruitment (Klesges et al., 1990). They were less likely to receive employment. Some were even discriminated against during pay – they received lower salaries than their counterparts did (Frieze et al., 1990).
Studies by Proper and colleagues argued that there was no relationship between employee performance and physical activity programs at the workplace (Proper et al., 2002). In their study, they focused on effectiveness. Therefore, they included the intervention trials only in the documentation search.
Other similar studies show that the association between fitness and other physical activities with work performance is not known. However, the health and wellness programs were shown to reduce absenteeism to a certain degree.
Pronk and colleagues reported a significant association between certain levels of physical exercise and the quality of work performance. The results also indicated a relationship between moderate and vigorous physical exercise and individual job performance. They concluded that those who had cardiorespiratory fitness required less effort to perform the same job.
This type of fitness had a relationship with the quantity of work done. This study is one of those studies that tried to provide a meaningful relationship between physical activities that try to ensure health and wellness of employees and their performance at work.
The workplace wellness programs are continuously providing many tangible benefits to the organizations. Research has provided evidence of an increasing support for the health and wellness programs in various businesses and organizations.
These programs are not limited to the big companies only but may be equally useful for the small businesses. Health care costs have been escalating and has raised serious concerns among the managers. This includes the health professionals, insurance companies and other employers.
The costs incurred by companies come in the form of insurance. Some of the health issues including diabetes and high blood pressure are common for overweight and obese individuals and companies insure them. Other habits such as smoking by the employees also contribute to health complications that need to be paid for by the companies.
The individuals with more risk factors cost the companies more than those with fewer risk factors do. The health and wellness programs help to improve the health of individuals who are already at risk. However, they also benefit the healthy individual. This is mainly through raising awareness of the importance of health. Therefore, they strive to maintain health and to prevent any risk factor such as being overweight.
It is obvious that employees spend most of their awake-hours at the workplace. This makes up about 50 hours every week. Therefore, it is the employees’ obligation to make use of the workplace health and wellness programs.
The programs have other benefits aside health benefits. Other benefits include the improvement of employee relations and morale. Therefore, a combination of these factors would be beneficial to the success of the organization.
Absenteeism is another aspect of employee performance that can be improved using the health and wellness programs. Research has suggested that healthier individuals spend more days at work than the unhealthy ones who need to be away from work occasionally as they seek treatment (Mundt, 1997). Work-loss days account for thousands or even millions of dollars as losses of the companies.
The health of the employees could also translate to better family choices. This means that these individuals would not need to be absent from work as they attend to the family members’ health issues (Simon et al., 2001).
Purpose of study
The purpose of this study is to determine the impact of health and wellness programs on performance of employees. With an increased awareness of the impact of health and wellness on the employees’ ability to work, it is necessary to investigate its impact on their performance.
This study will look at certain aspects of performance in order to determine whether health and wellness programs are necessary for the success of our organizations. The manifestation of the health and wellness programs will be determined by looking at the increase in physical fitness (physical activity) and reduced weight.
The reduction of the level of absenteeism can be measured as the additional days that the employees (who had previously out of work due to preventable illnesses) are available at the workplace following an increase in the level of health and wellness.
The aspects of performance will include the timeliness of performing work, the quality and quantity of work, and absenteeism (availability at the workplace). The aspects that are modifiable with the intervention of health and wellness programs include body weight and physical fitness. Additional aspects of performance will include the number of days that the employees were out of work.
Others include the employees’ performance (quality and quantity of work) at the workplace and their interpersonal relationships. This study will provide useful insight for any organization that is seeking to increase productivity of its employees through providing an assurance of their health and wellness.
Research questions
In order to determine the impact of health and wellness programs on performance of the employees, certain aspects of performance will be measured and analyzed.
What impact does health and wellness have on the employee’s self-appraisal and peer appraisal?
Does physical exercise contribute to increased physical fitness and the maintenance of weight at healthy levels?
Does increased physical fitness and reduced weight contribute to improved quality and quantity of work performed?
How is the timeliness of the performed work by the healthy individuals comparable with that of performed by an unhealthy lot?
Scope
Basically, every individual at the workplace will be involved in the study since everyone’s viewpoint and perspective will be considered. For self-appraisal, the individual employees will be consulted in order to get a view of their own performance. In order to reduce biasness in these views, the fellow employees will provide a peer appraisal of the employees in question.
In order to measure the quality and quantity of work performed, the management team will be consulted. The records of employee performance would greatly apply in this case. The views of the managers concerning the timeliness of the individual employees will be consulted.
Methodology
Research strategy
The research design that will be used will be the qualitative research design. This is because the human behavior and habits will be studied. The performance of the employees will be assessed in the context of the availability or unavailability of health and wellness programs. It will investigate whether these programs are useful for managers (in organizations) who want to make their employees more productive.
The variables that will be tested will include the aspects that indicate the outcomes of a health and wellness programs. These include the reduction of body weight, increase in physical fitness or physical activity and increase in the number of days that employees are present in the workplace. The indicators of performance include their timelessness, the quality and quantity of their work and the individual and peer appraisals.
Sampling strategy
For the investigation, 10 organizations will be selected within the area. Considering the amount of time and budget available for the research, this is a convenient and manageable number.
Therefore, the selection of the organizations will be a type of non-probability sampling technique and specifically the judgmental sampling. However, the organizations must not be in the same industry (performing similar businesses). This would ensure a representation of different employees from diverse working environments.
In each organization, 25 individuals will be selected randomly in order to reduce biasness. Of the 25 individuals, five were managers in the organizations. Therefore, a total of 200 employees and 50 managers will participate in the study.
The sampling technique that will be used to reduce bias but at the same time get a representation of the entire employee population will be the stratified sampling technique. This will also provide a higher statistical precision because the variability within the sub-groups will be lower when compared to variations that exist when the whole population is considered.
Data collection
Questionnaires were used to collect data. The kind of information that would be collected using the questionnaires includes the incidences of absenteeism. The employees would be asked to provide the number of days (including full days and partial days) that they were absent from work.
In order to understand the reason for absenteeism, the employees will be asked to include whether it was due to health issues, compulsory leave or other reasons. This is in order to avoid biasness when all incidences of absenteeism are assumed to be due to illnesses. In order to understand the characteristics of the employees, information such as age, sex and position in the company were inquired.
Questionnaires will be distributed to both the employees and managers. The data on self-appraisal and peer appraisal will be collected using the questionnaires distributed to the employees. Information on interpersonal behavior and other personal habits will also be collected using the same questionnaires and during interviews (Kobak et al., 1997).
This information is vital because it is also an indicator of performance. The information collected from the managers will include those involving the quality and quantity of work performed by their employees.
Additionally, a 5-point self-anchoring rating scale will be used to measure the employee’s quality of work. This measure will be applicable for situations where the employee is actually working (working hours).
The interference with the quality of work done will be measured by the score indicated. A score of one will indicate a significant level of interference with the quality of work done. A score of five, on the other hand, will represent no interference.
The amount of physical activity of the employees will be quantified using a special kind of questionnaire. This is referred to as the Godin Leisure Time Physical Activity questionnaire (Godin and Shephard, 1985). This information will be combined with the amount of weight lost due to the physical activities performed during the health and wellness programs.
Data analysis
Least squares regression analyses will be used to find the associations between the risk factors and the work performance. They will also be adjusted for sex, age and positions to determine the associations between physical activity, weight and performance.
In order to describe the characteristics of the population, several measures of central tendencies will used. Where applicable, graphs and charts will be used to analyze information in the questionnaires.
Validity and reliability
In order to ensure that the observed effects in the research are actually due to the variables, the intervening, extraneous and confounding variables will be controlled. This would be necessary to ensure that the realized health facilitated by the health and wellness programs were responsible for the increased performance of the employees. Reliability of the data collected will also be ensured.
The correct instruments and tools will be used in data collection. Since the data on the employees’ quality of work will be collected twice (using self-rating and rating from the managers), the parallel-forms or alternate-forms reliability will be used (Dillman, 1991). It will be used to assess the consistencies of the data from the two sources since it is the same variable measured at the same time.
Gantt chart
References
Aldana SG 2001, ‘Financial impact of health promotion programs: A comprehensive review of the literature’, Am J Health Prom, vol. 15, pp. 296–320.
Aldana SG & Pronk NP 2001, ‘Health promotion programs, modifiable health risks, and employee absenteeism’, J Occup Environ Med, vol. 43, pp. 36–46.
Anderson D, Whitmer RW & Goetzel RZ 2000, ‘Relationship between modifiable health risks and health care expenditures: a group level analysis of the HERO research database’, Am J Health Promot, vol. 15, pp. 45–52.
Dillman DA 1991, ‘The design and administration of mail surveys’, Annu Rev Sociol, vol. 17, pp. 225–249.
Frieze IH, Olson JE & Good DC 1990, ‘Perceived and actual discrimination in the salaries of male and female managers’, J Appl Social Psych, vol. 20, pp. 46–67.
Godin G & Shephard RJ 1985, ‘A simple method to assess exercise behavior in the community’, Can J Appl Sport Sci, vol. 10, pp. 141–146.
Goetzel RZ, Guindon AM, Turshen IJ & Ozminkowski RJ 2000, ‘Health and productivity management: establishing key performance measures, benchmarks, and best practices’, J Occup Environ Med, vol. 43, pp. 10–17.
Kessler RC, Greenberg PE & Mickelson KD 2001, ‘The effects of chronic medical conditions on work loss and work cutback’, J Occup Environ Med, vol. 43, pp. 218–225.
Klesges RC, Klem ML & Hanson CL 1990, ‘The effects of applicant’s health status and qualifications on simulated hiring decisions’, Int J Obes Relat Metab Disord, vol. 14, pp. 525–535.
Kobak KA, Taylor LH & Dottl SL 1997, ‘A computer-administered telephone interview to identify mental disorders’, JAMA, vol. 278, pp. 905–910.
Mundt JC 1997. ’Interactive voice response systems in clinical research and treatment’, Psychiatr Serv., vol. 48, pp. 611–612.
Narbro K, Jonsson E & Larsson B 1996, ‘Economic consequences of sick-leave and early retirement in obese Swedish women’, Int J Obes Relat Metab Disord, vol. 20, pp. 895–903.
Pelletier KR 1999, ‘A review and analysis of the clinical and cost-effectiveness studies of comprehensive health promotion and disease management programs at the worksite update’, Am J Health Prom, vol. 13, pp. 333–345.
Pronk NP, Tan AW & O’Connor PJ 1999, ‘Obesity, fitness, willingness to communicate and health care costs. Med Sci Sports Exerc, vol. 31, pp. 1535–1543.
Proper KI, Staal BJ & Hildebrandt VH 2002, ‘Effectiveness of physical activity programs at worksites with respect to work related outcomes’, Scand J Work Environ Health, vol. 28, pp. 75–84.
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Tsai SP & Gilstrap EL 1997, ‘Illness absence at an oil refinery and petrochemical plant’, J Occup Environ Med, vol. 39, pp. 455–462.
Tucker EL & Friedman GM 1998, ‘Obesity and absenteeism: an epidemiological study of 10, 825 employed adults’, Am J Health Promot, vol. 12, pp. 202–207.
Weinstein MC, Siegel JE, Gold MR, Kamlet MS & Russell LB 1996, ‘Recommendations of the Panel on Cost-Effectiveness in Health and Medicine’, JAMA, vol. 276, pp. 1253–1258.
The Finance Department at the health center is headed by a finance manager and has three other accounting officers. The role of the finance manager is to oversee the finance operations at the facility. The three accounting officers are tasked with different operational roles at the facility. The department also utilizes two other consultancy firms that assist with the auditing and tax remittances.
The Finance Department is responsible for all the financial operations at the health center. The department prepares all the annual budgets and makes recommendations on the various operations to be carried out based on the funds that are available. The department is responsible for developing and implementing strategies for revenue collection at the facility. The Finance Department is also tasked with the role of engaging with the payers such as insurance companies in following up on claims and implementing the required pay process (Burgess & Radnor, 2013). The health center’s finance department is also responsible for processing the staff’s salary as well as making payments for the related deductions.
Performance
The Finance Department at the health center has continued to demonstrate reliable performance, ensuring the organizational operations are not affected. In the last two financial years, the department has adopted new financial management systems that will enable it to improvement the revenue collection at the health center. The department also managed to successfully file all the taxes for the last three financial years hence avoiding the costs occurring due to delay in tax remittance. The department has also successfully managed to obtain all the revenue from the healthcare funders and other partners for the current financial period. The Finance Department has also successfully procured a credit facility with one of the pharmaceutical companies hence ensuring that the health center will not run out of these supplies.
Performance Appraisal Procedure
The Finance Department has managed to adapt its own performance approach based on the “360-degree-model” that is widely used at the health center. The staff at the department are provided with weekly targets that are well outlined and are required to submit a self-assessment report based on these targets every fortnight (Alsharf, 2015). The reports serve as the main input in the evaluation of their performance as they are awarded a percentage score by the finance manager. At the end of each month, the staff is requested to provide feedback on their colleagues at the department. The finance manager then uses the information to carry out the performance appraisal for his team and help identify areas of strength and the areas of weakness.
Medical Records
Structure and Overview
The Medical Records Department is headed by a headed by Medical Records Manager who works alongside five other staff members. For the department to ensure that its operations run efficiently, it has also engaged three other medical records personnel on a temporary basis to assist with various roles. The manager is responsible for making decisions regarding the role of the department in the overall operations of the health center as well coordinating the upgrades for the current electronic medical records system (Raghupathi & Raghupathi, 2014). The medical records personnel play crucial roles at the health center including data recording and verification to determine the authenticity.
The Medical Records Department is an integral part of the health center as it plays various critical roles. The department serves as the custodian of all the information and data for the patients that seek healthcare services at the health center. The department leads in all the data analytic operations to determine the healthcare trends at the facility. The Medical Records Department also serves as an integral part of the planning team as they offer insights on the operations based on the existing disease patterns (Bardhan & Thouin, 2013).
The department is also responsible for filing all the reports that are required by the state agencies for health. The medical department also collaborates with other primary healthcare organizations and state agencies to carry out appropriate research regarding disease patterns with the aim of informing the policy that governs healthcare provision.
Performance
The Medical Records Department managed to upgrade the current electronic medical records systems that are used at the health center to the latest version. The department has also managed to increase the number of data analytic reports that it provides monthly to facilitate better decision making at the facility. The department has also increased the number of computers that are available for organizations seeking to utilize the data from the health center. The Medical Records Department at the health center has also developed policy guidelines to help partner organizations when making requests to access the patient data from the facility for research purposes.
Performance Appraisal Procedure
The Medical Records Department has also developed an innovative method to apply the “360-degree-model” during its performance appraisal procedures. The department has a metric that is used to determine the staffs’ performance regarding completing various reports and implementing different strategies required to improve the operations at the health center. Another data input for the performance appraisal is the number of data analytics each staff has performed per year which helps to determine the level of initiative to improve the operations. All these inputs are employed by the manager in evaluating the staff during performance evaluation sessions that are held twice per year.
The Finance Department has managed to adapt its own performance approach based on the “360-degree-model” that is widely used at the health center. The staff at the department are provided with weekly targets that are well outlined and are required to submit a self-assessment report based on these targets every fortnight. The reports serve as the main input in the evaluation of their performance as they are awarded a percentage score by the finance manager. At the end of each month, the staff is requested to provide feedback on their colleagues at the department. The finance manager then uses the information to carry out the performance appraisal for his team and help identify areas of strength and the areas of weakness.
Quality and Excellence
Structure and Overview
The Quality and Excellence Department works towards improving the quality of service provided at the health center. The department is also tasked with the role of implementing new strategies to make the patient care at the facility to be aligned with the principles of patient-centered care (Mohammad, 2013). The department is also tasked with the role of ensuring that the health center is compliant to the relevant regulations governing the provision of primary healthcare.
The department is headed by a Quality Assurance Manager who works with a team of five personnel. The manager serves the role of developing policies to improve all the areas of operation at the health center. The other personnel at the department are tasked with the role of doing quality checks on the different areas within the health center. The department also engages external consultants to facilitate the review of the processes and develop various policies to facilitate the process of quality assurance.
Performance
The Quality and Excellence Department at the health center has been conducting quality training for all the clinical staff at the health facility in the past three months with a focus to help reduce infection control. The department also created a system for patients to raise complaints regarding the services provided at the facility. The department has also established a weekly training program through which they intend to train the patients concerning their rights as part of their patient advocacy operations. The Quality and Excellence Department has also been working with the medical records personnel to develop a new system for health informatics that will be used to analyze data at the health center.
Performance Appraisal Procedure
The Quality and Excellence Department implements the “360-degree-model” in a manner that enables the department to meet its objectives. Given that most of the roles are carried out in a team set up, each staff are requested to provide feedback on their colleague before the assessments are carried out. The feedback is sent to the manager either in written or verbal form. The manager uses this feedback to rate the staff during the monthly performance review sessions. The performance appraisal also serves as a session for the manager to set goals for the staff regarding the quality initiatives that they should undertake.
Management Cycle
All the three departments employ an innovative management cycle aimed at facilitating the provision of quality services. The management cycle in three departments starts with the development of a measure and achievable objectives. The managers in each department are tasked with overseeing the implementation of the various objectives together with their teams (Langabeer & Helton, 2015). The managers are expected to provide their teams with regular feedback based on their general performance. The final stage of the management cycle includes the review of the objectives to determine if the team have achieved all their objectives and to set the objectives for the next cycle.
References
Alsharf, I. A. (2015). Performance Management in Healthcare. Journal of Applied Management and Investments, 4(1), 45-52.
Bardhan, I. R., & Thouin, M. F. (2013). Health information technology and its impact on the quality and cost of healthcare delivery. Decision Support Systems, 55(2), 438-449.
Burgess, N., & Radnor, Z. (2013). Evaluating lean in healthcare. International Journal of Health Care Quality Assurance, 26(3), 220-235.
Langabeer II, J. R., & Helton, J. (2015). Health care operations management. Massachusetts: Jones & Bartlett Publishers.
Mohammad, A. (2013). Healthcare service quality: Towards a broad definition. International Journal of Health Care Quality Assurance, 26(3), 203-219.
Raghupathi, W., & Raghupathi, V. (2014). Big data analytics in healthcare: promise and potential. Health Information Science and Systems, 2(1), 3-8.
The significance of sleep cannot be underestimated. Numerous studies point to the necessity of developing sleep patterns involving at least eight hours of nocturnal sleep. However, younger people usually do not follow this recommendation either due to their social life or university schedules. Because some university classes begin as early as 7 o’clock in the morning and finish in the evening, the only option for such students is to reduce the length of night-time sleep in order to meet the academic performance requirements.
For this reason, it is paramount to determine what are the consequences of both adequate and inadequate sleep patterns on academic performance and achievement. The primary focus will be made on medical field students, international students, and interventions used for decreasing the negative influence of inadequate sleep patterns.
First of all, it is vital to note that developing a sleep pattern varies with regard to individual needs because some people prefer going to bed and waking up early while others are more active at night and less productive in the mornings. The same can be said about taking naps during a day, as they depend on the personal preference.
Nevertheless, the findings of the researches argue that there is no direct connection between a particular sleep pattern and academic performance. The only important detail is that an individual sleeps no less than six hours during the night and takes a nap during the day (Ali et al. 1995). Similar sleep patterns are common for students demonstrating outstanding and above average academic results. Moreover, there is a link between sleep pattern and gender because their impact on male students is less powerful than on women (Nihayah 617).
The influence of sleep patterns on academic performance and achievement can be explained by the fact that inadequate length of night-time sleep results in sleepiness during the day, inability to wake up at planned hours, stress, unwillingness to attend university classes and meet academic requirements as well as the increase of the risks of developing insomnia symptoms (Alsaggaf et al. 180).
In addition to it, inadequate sleep hours have a negative influence on working memory, language, and reasoning (Zeek et al. 63). Moreover, it affects the efficiency of learning languages (BaHammam et al. 64). It means that international students, especially those studying in foreign languages, are exposed to higher risks of failing to meet academic requirements and demonstrate lower levels of academic performance and achievement.
Nevertheless, there are several feasible options recommended for overcoming the challenge of academic failure related to inadequate sleep. One of them is promoting educational programmes on sleep hygiene, i.e. quiet environment and using an individual’s bed only for sleep, not as a place to learn or eat. Another effective technique is attending sleep courses offering knowledge of sleeping hygiene, muscle relaxation before sleep, and teaching to improve sleep behaviour.
There are also some modern interventions aimed at handling this problem known as electronic cognitive behavioural therapy. The idea is similar to sleep courses because students receive the information on some aspects of sleep offered by the tutors. However, in this case, there is no direct communication, as all details are sent via e-mail on a timely basis (Hershner and Chervin 80-81).
To sum up, inadequate sleep patterns are a significant concern. It is especially severe in case of medical field students due to vast amounts of learning materials and high academic requirements. Because they are forced to reduce the length of night-time sleep, their academic performance suffers. Nevertheless, taking naps during the day and improving sleep behavior are the best options, which might be used to cope with this challenge.
Works Cited
Ali, Aabid, Muhammad Bilal Majid, Kanwal Saba, Amanda Bodenarain, and Mulazim Hussain Bukhari. “Effects of Different Sleeping Patterns on Academic Performance in Medical School Students.” Natural Science 5.11 (2013): 1193-1198. Print.
Alsaggaf, Mohammed, Siraj O. Wali, Roah A. Merdad, and Leena A. Merdad. “Sleep Quantity, Quality, and Insomnia Symptoms of Medical Students During Clinical Years.” Saudi Medical Journal 37.2 (2016): 173-182. Print.
BaHammam, Ahmed, Abdulrahman M. Alaseem, Abdulmajeed A. Alzakri, Aljohara S. Almeneessier, and Munir M. Sharif. “The Relationship Between Sleep and Wake Habits and Academic Performance in Medical Students: A Cross-Sectional Study.” BMC Medical Education 12 (2012): 61-66. NCBI Library. Web. 11 Jul. 2016.
Hershner, Shelley, and Donald Chervin. “Causes and Consequences of Sleepiness Among College Students.” Nature and Science of Sleep 6 (2014): 73-84. NCBI Library. 2016.
Nihayah, Mohammad, Ishak Ismarulyusda, Nur Zakiah, Omar Baharudin, and Mohammad Fadzil. “Sleeping Hours and Academic Achievements: A Study Among Biomedical Science Students.” Procedia – Social and Behavioural Sciences 18 (2011): 617-621. Print.
Zeek, Megan, Matthew J. Savoie, Matthew Song, Leanna M. Kennemur, Paul W. Jungnickel, and Salisa C. Westrick. “Sleep Duration and Academic Performance Among Student Pharmacists.” American Journal of Pharmaceutical Education 79.5 (2015): 63-70. NCBI Library. 2016.
The outcome measures apply to an adult mental health facility with two units, unit Bravo and unit Charlie. The target patient population is adult patients diagnosed with mental illness.
– Timely care delivery – Patient safety/patient-centered care – High responsiveness – Customer satisfaction
Operational effectiveness
– Accurate data collection – Accreditation
– Data collection systems/tools – Length of stay – Readmission rate
Financial viability
– Cost savings – Timely payments
– Inventory turnover – Net revenue increase
Outcome Measures
Performance – this indicator measures the extent to which the care rendered meets patient, family, or provider expectations. The selected outcome measures for this indicator include:
The proportion of clients/families satisfied with the care/service as measured with 30-day user appraisals.
The percentage of acute referrals treated within 24 hours.
Quality – because of the refractory nature of mental illnesses, hospital readmission rates, and committals are indicators of the quality of care provided. Its outcome measures include:
The total readmissions at the two units within a 30-day post-discharge period as a percentage of psychiatric cases handled per annum.
The number of cases put under involuntary committals or seclusion relative to the total hospitalizations per year.
Patient safety – adverse events, suicides, and homicides can indicate the patient risks associated with an intervention. The two selected outcome measures for this indicator include:
The number of clients under electroconvulsive therapy (ECT) who get fractures, tooth loss, and myocardial infarctions
The number of client-reported medical error cases received by the case manager in 30 days
Employee engagement – effective engagement programs enhance staff motivation, retention, and capacity, translating into greater unit efficiency. The outcome measures for this indicator include:
The proportion of the institution’s annual budget spent on staff engagement activities
The overall staff turnover rate per annum
Necessary Processes
Performance
The identified outcome measures of performance are patient/family satisfaction rates and referrals assessed per day. First, service evaluations by the mental health consumers indicate the client’s “experiences with services, service providers, and service coordination” or satisfaction levels (McEwan & Goldner, 2001, p. 4). Therefore, higher levels of satisfaction indicate performance improvement, i.e., the care provided meets the needs and expectations of the patient/family. Second, waiting time is a good indicator of healthcare accessibility. Quick intervention can prevent exacerbation of mental illness. Therefore, the rate at which acute referrals are assessed determines care accessibility, a core dimension of performance.
Quality
Quality also has two outcome measures, i.e., readmission rate and incidence of involuntary committals. The high 30-day readmission rate implies poor quality care, inadequate care continuity, or inefficient post-discharge support (McEwan & Goldner, 2001). On the other hand, the use of involuntary committals or restraints suggests an inability to provide appropriate/quality care and inadequate staff skills to supervise patients.
Patient Safety
The identified outcome measures for patient safety are the adverse events experienced by clients and medical error rates. Medical complications such as “myocardial infarction, bone fracture, aspiration, and teeth damage” are linked to the use of ECT in patients diagnosed with mental illnesses (McEwan & Goldner, 2001, p. 7). Thus, these complications drive patient safety measures. Additionally, medical errors arising from the adverse effects of neuroleptic prescription, administration, or non-adherence can be a good outcome measure for patient safety.
Employee Engagement
The two outcome measures for employee engagement include staff engagement spending and turnover rates. First, a substantial budgetary allocation made to areas such as employee training and development, compensation, and good performance awards to boost morale and capacity will indicate adequate employee engagement. Secondly, engaged employees are less likely to leave an institution than disengaged ones (Lockwood, 2007). Therefore, the staff turnover rate will indicate the efficiency of the current engagement programs.
Additional Indicators
Care continuity is a vital indicator of intervention efficiency in mental care settings. It can be described as the capacity to offer “uninterrupted, coordinate care” across institutions/settings over a given period through case management (McEwan & Goldner, 2001, p. 8). One outcome measure for care continuity is the number of clients received by case managers after discharge. The rationale here is that continuity methods help support coordinated care for clients with complex needs. A streamlined continuity of care also reduces emergency room visits. Therefore, the nurse leader could monitor the number of ER visits made by patients diagnosed with mental illness annually. High ER visits would indicate a disruption in the continuity of care or inadequate social support.
A post-discharge follow-up of patients with chronic psychiatric episodes is another outcome measure for the continuity of care. A responsive support mechanism is required to preclude 30-day readmissions after discharge. Therefore, ensuring high psychiatric service contacts with vulnerable client groups would enhance treatment outcomes. Conversely, a high number of cases lost to follow-up is high would indicate a poor tracking of patients or care continuity breakdown.
Another core measure for this indicator is the integration of persons diagnosed with mental illness into the community upon discharge. Inpatient clients receiving care at tertiary facilities should be integrated into their rural communities after discharge. A successful return and integration of these persons is a good measure of community/family capacity to support the patients and collaborate with caregivers. Therefore, monitoring how well the clients integrate back into the community will enable the nurse leader to measure the efficiency of continuity of care mechanisms.
Advantages
Implementing a performance data scorecard in a healthcare setting comes with multiple benefits. First, a scorecard gives a framework for aligning strategic objectives with patient-centered care. According to Inamdar and Kaplan (2002), a balanced scorecard enables institutions to translate their “missions, values, visions, and strategies” into performance measures in the areas of finance, staff development, internal processes, and client needs (p. 184). The performance scorecard created will enable the mental health unit to actualize its goals through concrete performance measures in the domains of quality, employee engagement, performance, and patient safety. Huang, Chen, Yang, Chang, and Lee (2004) write that a scorecard operates as a “strategic management system” with clear implementation processes (p. 144). Therefore, the second benefit of the scorecard is that it will enable the organization to adopt strategic processes and activities to support its operations in the four areas.
Third, the scorecard created will enhance multidisciplinary communication and collaboration with the Bravo and Charlie units. Using this scorecard, each individual within the units will assume a certain responsibility in implementing the strategy. Therefore, it will support greater accountability through improved performance comparisons between departments within the institution. Fourth, the assessment of the outcomes and drivers would require a reporting system to evaluate the progress. Thus, it will foster continuous improvement by creating a learning culture in the organization. Fifth, the scorecard will guide resource allocation towards interventions that enhance the accessibility of mental health services, continuous quality improvement, regulatory compliance, and patient safety, among others (Inamdar & Kaplan, 2002).
Current Trends
In healthcare, employee engagement is associated with improved “patient satisfaction, safety, and quality” (Lowe, 2012, p. 31). One current trend is the increasing role of leadership/supervision in a top-down implementation of engagement programs. In this case, the top management, e.g., hospital managers, spearhead continuous intrinsic engagement efforts, including training and development, to enhance efficiency and reduce nursing turnover. The various teams/employees are taught how their efforts contribute to the realization of organizational goals. Extrinsic engagement approaches, such as monetary rewards, workload balance, pay increases, and promotions, are also used to achieve the same purpose.
The second trend relates to the growing focus on trust-building as the key to greater engagement levels. Hospital managers espouse “respect, fairness, and integrity” in their interaction with staff (Bulkapuram, Wundavalli, Avula & Reddy, 2015, p. 52). They build a culture of professional autonomy and evidence-based practice to build trust, which leads to positive employee experiences. Recent evidence indicates that healthcare institutions are increasingly empowering the middle-level managers to oversee the corporate strategy and promote effective personnel practices (Bulkapuram et al., 2015). The rationale for this trend is that an engaged staff shows trust towards the management and have higher job satisfaction than disengaged ones. To this end, the managers promote an atmosphere of openness and trust.
Employee Engagement and Healthcare Quality
A strong correlation exists between staff engagement levels and retention rates. Lowe (2012) found that, among engaged hospital staff, only 17% indicated the intent to leave their institution compared to 43% of the disengaged ones. Thus, higher engagement levels increase the retention of critical clinical staff that is needed to support quality care delivery. Further, staff engagement contributes to a healthy work environment. According to Roussel (2015), an environment of engagement can be characterized by a mutual reinforcement between “worker health and patient care quality” (p. 67). Therefore, hospitals with engagement (clinical training) programs provide a healthy work environment that supports evidence-based interventions.
Quality care delivery is one that centers on the patient. Providing patient-centered care indicates a hospital’s commitment to quality improvement and patient safety. One study found out that an engaged staff viewed the work environment as being patient-centered while disengaged employees viewed it as being less patient-centric (Lowe, 2012). Therefore, engagement improves the emotional state of the staff, motivating them to utilize personal resources to deliver patient-centered care. Another dimension of quality is patient safety. Employee engagement is associated with skill improvement through training and development. The engagement programs empower the clinical staff to perform better and avoid medication errors. It also builds a culture of collaboration and trust, leading to superior job performance.
Current Tools
Our hospital has adapted the Employee Engagement Survey (EES) tool to capture staff engagement data. The tool is based on the healthcare workplace framework of the Ontario’s Hospital Association (McEwan & Goldner, 2001). It captures engagement drivers as well as staff and institutional outcomes. Data related to workplace conditions, job attributes, and perceived management support are collected to inform the engagement strategy. Additionally, the questionnaire captures nurse outcomes such as employee safety, turnover rates, and performance. Therefore, this tool provides nurse leadership with comprehensive baseline data on several useful engagement drivers.
However, the tool omits data on patient-centered care delivery and safety. Patient-centered care and patient safety are indicators of the quality of care delivered. The exclusion of these two indicators results in insufficient data to evaluate the impact of engagement initiatives. Further, the hospital lacks an assessment tool for each engagement strategy. Consequently, it may be difficult for nurse leadership to determine the most effective approach between intrinsic and extrinsic engagement programs. Moreover, employee demographic characteristics, e.g., age and cultural background, may affect the effectiveness of an engagement strategy. Therefore, a tool that compares the efficacy of different engagement strategies applied to various employee groups would be more appropriate.
Improving Employee Engagement
Communication
Goals
Strategies
Evaluation
Timeline
Establish employee briefing sessions
Biweekly face-to-face briefing sessions
Number of attendees
Oct. – Dec. 2016
Build staff feedback mechanisms
Quarterly workshops
Quantity/quality of feedback received
Nov. 2016
Provide all workers institutional emails/ access to PC
Formal induction
Social media use
Number of users per month
Jan. 2017
Performance management
Create clear job descriptions for each position
Unit managers will ensure tasks match the position
Number of workload/burnout complaints
Feb. – Mar. 2017
Each worker to have a personal development plan (PDP)
Unit managers will help each employee create a PDP
The proportion of employees with PDPs
Mar. – Apr. 2017
Conduct regular PDP reviews
PDP review training for unit managers
Number of unit managers trained
May 2017
Reward/recognition
Recognition of outstanding staff in the annual event
Employee nomination of excellent performers
Number of employees recognized annually
Dec. 2016
Monthly non-monetary rewards
An employee of the month accolades
Number of recipients per annum
Jan. – Dec. 2017
Development opportunities
Talent & succession management
Identify emerging leaders for an annual succession development program
Number of employees trained annually
Jun. 2017
Multidisciplinary training of staff
Establish multidisciplinary programs
The proportion of the staff trained annually
Nov. 2016 – Nov. 2017
Leadership Best Practices
Effective employee engagement has multiple benefits for the organization. Therefore, best practices in employee engagement are important. The top management should support staff engagement as a strategic priority for the institution. It should be explicitly included in the institution’s strategic plan and adopted at all levels of the organization. Another best practice entails a top-down communication of the organizational mission, objectives, and principles to support engagement initiatives. A shared vision has a unifying effect on the staff, contributing to greater staff participation (Sullivan, 2013). Staff involvement through feedback mechanisms is also considered an engagement best practice. The worker’s voice or input can be sought through surveys, debates, and discussions (Lockwood, 2007). Such approaches empower employees to share their ideas with management about organizational goals and strategies.
Enhanced accountability within the organization is also associated with high engagement levels (Lockwood, 2007). Demanding a high degree of accountability at all managerial levels influences team engagement and performance. In such cases, the line managers apply balanced scorecards to assess performance and “align the systems” with incentive initiatives (Lockwood, 2007, p. 6). The leadership should also implement staff-focused policies to cater for the social and emotional needs of the workers. Caring for workers increases staff motivation and engagement.
References
Bulkapuram, S., Wundavalli, L., Avula, K., & Reddy, K. (2015). Employee Engagement and its Relation to Hospital Performance in a Tertiary Care Teaching Hospital. Journal of Hospital Administration, 4(1), 48-57.
Huang, S., Chen, P., Yang, M., Chang, W., & Lee, H. (2004). Using a Balanced Scorecard to Improve the Performance of an Emergency Department. Nursing Economics, 22(3), 140-148.
Inamdar, S.N., & Kaplan, R.S. (2002). Applying the Balanced Scorecard in Healthcare Provider Organizations. Journal of Healthcare Management, 47(3), 179-196.
Lockwood, R. (2007). Leveraging Employee Engagement for Competitive Advantage: HR’s Strategic Role. SHRM Research Quarterly, 1, 1-12.
Lowe, G. (2012). How Employee Engagement Matters for Hospital Performance. Healthcare Quarterly, 15(2), 29-40.
McEwan, K., & Goldner, E. (2001). Accountability and Performance Indicators for Mental Health Services and Supports: A Resource Kit. Ottawa: Health Canada.
Roussel, L. (2015). Management and leadership for nurse administrators. Burlington: Jones and Bartlett Learning.
Sullivan, E. (2013). Effective leadership and management in nursing. New York: Prentice Hall.
Healthcare workers use their competencies to provide high quality support and care to their patients (Bouphan, Apipalakul, & Ngang, 2015). Hospitals should have powerful policies to measure the performance of their employees. Effective performance measurement can make it easier for healthcare facilities to understand how they accomplish their objectives. When done efficiently, performance measurement can guide hospitals to understand what is not working effectively. Evidence-based data should be gathered in order to implement better healthcare delivery models (Lizarondo, Grimmer, & Kumar, 2014). Performance measurement is therefore defined as “the regular collection of information and data to ensure various processes are implemented in a professional manner” (Kundu, 2015, p. 20). The ultimate goal should be to deliver quality care to the targeted patients. This discussion therefore presents a powerful healthcare policy in this field.
Performance Evaluation Policy
Purpose
The proposed Performance Evaluation Policy is aimed at monitoring, guiding, and ensuring every healthcare worker acts diligently in order to improve the health outcomes of the targeted clients. Medical institutions are characterized by different departments. The units have qualified healthcare professionals who work together to maximize the health outcomes of the targeted patients. This situation might have adverse effects on the quality of services available to every client. This is the case because some workers might fail to act ethically or use their skills effectively (Bouphan et al., 2015). The healthcare working environment is also characterized by a wide range of uncertainties, risks, and challenges. Nurse Practitioners (NPs) and caregivers must overcome these challenges in order to deliver quality care to their clients. There are also different regulatory boards that monitor the responsibilities and performance of health practitioners. However, such regulations and obligations might not guarantee positive performance in different working environments (Nuti, Seghieri, & Vainieri, 2012). This gap, therefore, explains why a performance evaluation policy is needed to guide and hold NPs accountable. By so doing, the policy will compel practitioners to focus on the health outcomes of their respective clients.
Definitions
Policy. The proposed policy is a performance evaluation process that must be completed for every healthcare worker annually (Lizarondo et al., 2014). The supervisors in every health organization will guide the professionals to complete the policy documents and make the most appropriate adjustments.
Appraiser. This term refers to the team leader or supervisor whose role is to complete the performance evaluations for the employees. The healthcare workers will be appraised after every twelve months.
Evaluation. This refers to the formalized procedure through which the performance of an employee is evaluated to provide the best feedback.
Duties
The performance evaluation policy targets different healthcare professionals in every hospital. The targeted practitioners should use their competencies in an attempt to provide professional and sustainable care to the clients (Kundu, 2015). The performance of each professional will be governed by this policy. The targeted duties include:
Hospital Administrator (NA). The NA is expected to ensure there is a framework for assessing the performance of every employee in the healthcare institution.
Supervisor. This is the individual responsible for the annual evaluation of the employees annually. The institution might also allow the targeted employees to present their personal evaluations (Nuti et al., 2012). Throughout the evaluation process, the supervisor will guide and empower the healthcare workers. He or she should liaise with the top management in order to support the assessment process.
Healthcare Workers. These are the individuals who are engaged throughout the evaluation process. This category includes different professionals such as Nurse Informaticists (NIs), Nurse Practitioners (NPs), physicians, Nurse Managers (NMs), caregivers, and nurse aids (Bouphan et al., 2015). These workers play a positive role towards supporting the diverse needs of the targeted clients.
Nurse Manager. This professional will guide the nurses to be part of the policy. The approach will ensure the employees are aware of the importance of the performance evaluation initiative. The NM will collaborate with the supervisor in order to deliver positive results. The manager will embrace the best practices in an attempt to support the diverse needs of the healthcare workers (Lizarondo et al., 2014).
Human Resources. The human resources will be responsible for “the oversight of this appraisal system, policy, and overall development of the process” (Nuti et al., 2012, p. 3). The HR department should constantly use the collected forms to make appropriate decisions regarding transfers and promotions. The assessment process will encourage health professionals to worker harder in order to provide quality care to their respective patients.
Body of Policy
Issue Statement. Employee evaluation in a hospital is the best way to ensure nurses focus on the expectations of their patients. The performance management and evaluation policy (PMEP) is aimed at measuring healthcare delivery effectiveness in hospitals (Kundu, 2015). The workers will be compelled to function optimally and focus on the targeted objectives.
Policy Position. Many agencies such as the American Nursing Association (ASA) believe that healthcare practitioners should be evaluated periodically in order to maximize patient outcomes. The performance evaluation model should assess the productivity of the NPs in accordance with the outlined responsibilities. The evaluation should focus on specific attributes such as leadership, judgment, and ability to communicate effectively. The caregivers should be on the frontline to deliver evidence-based, quality, and timely patient support. Supervisors will be “expected to provide evaluate feedback to the workers” (Bouphan et al., 2015, p. 129). Different stakeholders should be allowed to support the policy in order to produce positive results. The NPs and caregivers should collaborate with different supervisors throughout the process. The process will play a positive role towards empowering, mentoring, and supporting the performance of the healthcare workers.
Role of the Institution. The hospital should develop and implement the best framework to provide feedback to the healthcare workers. The framework should also measure the progress of the targeted employees. This framework will play a positive role towards improving the performance of the healthcare facility (Nuti et al., 2012).
Implementation
A powerful process will be used to implement the performance management and evaluation policy. The implementation procedure will have these three steps:
Evaluation. Using the PMEP document, the performance of the employees will be assessed after every twelve months. Performance appraisal can be conducted when a healthcare worker is being sacked or transferred (Kundu, 2015). Reviews and suggestions will be indicated in the PMEP forms.
Review and Analysis. The supervisor will guide the workers to sign the PMEP document. The employees will be allowed to retain a copy of the PMEP document. The supervisor will then forward the signed forms to the human resource (HR) department (Lizarondo et al., 2014). The HR managers will review the information and make the most appropriate recommendations.
Monitoring Compliance
The issue of compliance must be taken seriously. Healthcare workers who transfer during the indicated period for evaluation will have to liaise with their supervisors. This practice will ensure the performance evaluation is executed in a professional manner. The supervisor will be expected to collect quality information from the targeted employees (Nuti et al., 2012). The healthcare workers will have to collaborate with their supervisors throughout the assessment period.
The HR department, the supervisors, and the management must collaborate to monitor the performance of the workers. The policy should be implemented in each department to guide the performance of the employees. Recommendations and suggestions should be presented by the supervisors. The collected PMEP forms from the workers will be used to make the most desirable recommendations (Nuti et al., 2012). Healthcare workers will be promoted depending on the information gathered using the performance evaluation process.
The appraisal process must have been completed within two months after the end of the year (Kundu, 2015). The supervisors (or appraisers) will be required to send to filled forms to the HR department. The appraiser should also attach the relevant supporting documents whenever sending the files to the HR manager. In order to maximize the targeted outcomes, several stakeholders will be considered throughout the implementation process (Lizarondo et al., 2014). These stakeholders will include Medical Managers, Information Technology Experts, Financial Officers, Quality Assurance (QA) Managers, and the Nursing Managers (NMs).
Part Two: Healthcare Procedure
Performance evaluation can be implemented in a healthcare institution to improve the quality of services available to different clients. The first approach towards having a successful performance evaluation process is through the use of a powerful policy. The policy suggested in Part One can help medical institutions to assess the performance of every caregiver. This is a tested approach that has continued to support the effectiveness of different medical facilities across the globe. The second approach is the use of a powerful healthcare procedure. The approach encourages different stakeholders and workers to evaluate their contributions in a department. The framework plays a critical role towards identifying the existing gaps and improving the quality of patient care (Lizarondo et al., 2014). The proposal below gives a detailed healthcare procedure that has the potential to support the performance evaluation philosophy of a hospital. The proposed healthcare procedure is known as the integrated employee evaluation process (IEAP).
Integrated Employee Evaluation Process
Healthcare professionals work synergistically in a hospital to address the diverse needs of their clients. Human beings are social beings and tend to work together as teams. The concept of teamwork is critical towards ensuring that every hospital provides desirable support to their patients. Medical facilities have embraced the use of performance evaluation to assess the effectiveness of their employees (Nuti et al., 2012). However, performance evaluation has been observed to focus on the contributions of individual healthcare workers. The integrated employee evaluation procedure can be implemented as a meaningful healthcare procedure capable of minimizing the gaps affecting the quality of care available to every client. The integrated employee evaluation process (IEAP) framework therefore borrows most of the associated with lean.
Objectives
The recommended healthcare process should be guided by the three objectives presented below. The objectives will help medical facilities understand the contributions of different employees and the best approaches to improve performance.
Monitor and evaluate the performance of the healthcare professionals.
To make the most appropriate administrative decisions about the healthcare workers in the health organization. Some of these decisions include dismals, compensations, layoffs, and promotions.
Identify the best opportunities for employees’ growth based on their strengths and competencies.
Definitions
Healthcare Procedure. This refers to the integrated employee evaluation process that should be implemented in a healthcare institution (Kundu, 2015). The procedure will be characterized by continued analysis and evaluation of the activities undertaken by different healthcare workers.
Evaluation. This refers to the formal procedure through which the responsible leaders will analyze the performance of the targeted caregivers. The process will outline the gaps and strengths that influence the quality of health services available to the clients.
Monitoring. This term focuses on the continuous analysis of the engagements, activities, and goals of the employees (Lizarondo et al., 2014). The process has the potential to identify the existing gaps and propose new processes to improve the nature of healthcare delivery.
Lean. This concept refers to a powerful strategy aimed at examining the gaps affecting performance. The framework goes further to propose new strategies towards improving the level of employee performance (Lizarondo et al., 2014).
Employee Growth. One of the objectives of the suggested healthcare procedure is to identify the challenges making it impossible for caregivers to offer quality services. The performance evaluation process should be aimed at empowering the workers depending on their competencies (Kundu, 2015). The leaders will identify the existing gaps and offer new ideas to promote employee growth. The practice will eventually improve the nature of healthcare services.
Roles and Responsibilities
The healthcare procedure will be guided by a number of roles and responsibilities (Kundu, 2015). The procedure will be characterized by different professionals in order to produce positive results. These leaders (and their respective responsibilities) are presented below.
Nurse Manager (NM). This professional will guide the employees in the institution to be part of the procedure. The NM will collaborate with the workers in order to deliver positive results. The manager will identify the strengths and weaknesses of the targeted healthcare workers.
Human Resource (HR) Management. The HR manager will monitor the performance of the health professionals. This manager will analyze the behaviors of the employees (Lizarondo et al., 2014). The department will outline the grievances and challenges affecting different units.
Hospital Management. The role of the top managers is to monitor the goals of the hospitals and examine the contributions of different workers. By so doing, the management will understand the issues affecting the hospital (Lizarondo et al., 2014). The major areas for improvement will be identified. The management will implement and support the use of the lean concept. This concept will ensure the most appropriate improvements are guided by the challenges affecting the quality of care available to the targeted clients.
Healthcare Workers. The healthcare practitioners will be required to support the procedure. These professionals will have to collaborate with the HR manager and the top leaders in order to implement the procedure (Kundu, 2015). They should also cooperate in order to implement the best training practices.
Process
A top to down strategy is proposed for this healthcare procedure aimed at promoting performance evaluation. The senior managers will be required to initiate the process. They will begin by “examining and evaluating the effectiveness of the healthcare practitioners using various parameters” (Lizarondo et al., 2014, p. 578). Some of these parameters include ability to work in teams, deliver of adequate services, addressing workplace problems, decision-making, and empowering patients (Kundu, 2015).
The institution should design an appropriate framework to determine if an employee has been able to support the expectations of the healthcare facility (Lizarondo et al., 2014). This process will make it easier for the management to identify the achievements and philosophies of the healthcare workers. The main focus should be on the quality of healthcare services available to the patients.
The healthcare professionals in the institution should be required to fill up their personal performance evaluation forms. The workers should outline their responsibilities, competencies, and weaknesses. They should also outline their models towards supporting the diverse needs of their patients. The supervisor should use this information to highlight the achievements and competencies of every health practitioner (Grigoroudis & Zopounidis, 2010). The top management should use these performance evaluation documents to make the most desirable conclusions.
The next important thing is to implement the concept of lean. This approach will identify the weaknesses or issues affecting some of the healthcare workers. The gathered information will be used to design powerful models to empower the followers. The process will improve their skill sets and equip them with better organizational competencies (Grigoroudis & Zopounidis, 2010). Continuous improvement should be implemented as part of the healthcare procedure. This means that new ideas and practices will be considered in order to ensure the healthcare practitioners in the facility work hard to maximize patient outcomes.
Compliance
The health leaders, supervisors, and NMs will have to collaborate in order to monitor the performance of different caregivers. The procedure should be implemented in each department to monitor and evaluate the performance of the healthcare professionals. Recommendations and suggestions should be presented to the HR department. The practitioners will be guided to focus on the proposed healthcare procedure (Grigoroudis & Zopounidis, 2010). The strategy should be embraced as a critical aspect of the institution aimed at improving the level of performance. The gathered information will be used to implement a powerful lean model that can improve the competencies of the workers. This practice will eventually ensure the targeted employees work hard to maximize the health outcomes of their respective patients.
Evaluation and Recommendations
The healthcare procedure should be characterized by a number of practices to improve the level of performance evaluation. The evaluation process should be done continuously in the hospital. The procedure will identify the existing gaps and offer new suggestions to improve the level of performance. Several recommendations have the potential to make a difference for nursing institutions. For instance, there should be positive communication between the subordinate and the superior in the healthcare organization (Grigoroudis & Zopounidis, 2010). Whenever a problem is identified, third parties should be allowed to intervene in order to minimize biasness. Training should be implemented as part of the healthcare procedure. This practice will empower the healthcare workers and eventually improve the level of performance. The management should match the needs of the workers with the available resources. This approach will ensure the implemented healthcare process supports the ultimate goal of performance evaluation. New improvements will be implemented and ensure the healthcare facility becomes a leading provider of sustainable medical services.
References
Bouphan, P., Apipalakul, C., & Ngang, T. (2015). Factors affecting public health performance evaluation of sub-district health promoting hospital directors. Procedia: Social and Behavioral Sciences, 185(1), 128-132.
Grigoroudis, E., & Zopounidis, C. (2010). Developing an employee evaluation management system: The case of a healthcare organization. Working Paper, 1(1), 1-19.
Kundu, P. (2015). Performance evaluation of hospital employees through ongoing appraisal systems. International Journal of Thesis Projects and Dissertations, 3(2), 19-27.
Lizarondo, L., Grimmer, K., & Kumar, S. (2014). Assisting allied health in performance evaluation: A systematic review. BMC Health Services Research, 14(1), 572-589.
Nuti, S., Seghieri, C., & Vainieri, M. (2012). Assessing the effectiveness of a performance evaluation system in the public health care sector: Some novel evidence from the Tuscany region experience. Journal of Management and Governance, 1(1), 1-11.
Performance-enhancing substances legalization is impossible
People always try to compete and prove that they can do something better than others. Interestingly, the word competition “derived from the Latin “come together” has obtained the English meaning of “a trial of skill or ability; a contest” (Bahrke v). Thus, sport is a trial of human abilities and professional skills. However, competitors seek for enhancing their natural abilities with the help of performance-enhancing substances.
Admittedly, this is not a new trend. For instance, ancient Greeks used “hallucinogenic mushrooms” to improve their performances; Africans used Cola to enhance their running performance (Bahrke vii). Moreover, athletes of the 19th century used cocaine and other heavy drugs, and the athletes of the 20th century excessively used various anabolics and stimulants (Bahrke 3-5).
It is necessary to add that only in the middle of the 20th strict performance-enhancing substances bans were issued. However, at the moment many claim that such ban should be abolished and it is necessary to legalize the use of “not dangerous” performance-enhancing substances (hereinafter also referred to as “drugs”). These people provide many arguments for such legalization stating that it could improve the control process over drugs use, save finance used on costly doping test.
They also refer to some ethic issues claiming that sport itself can cause various problems in athletes’ future lives (just like drugs), besides, drugs only improve performance but not presuppose unnatural physical strength, and, finally, it could be beneficial to make science and sport interrelated.
Nevertheless, it is impossible to legalize the use of performance-enhancing substances due to the number of incompatible arguments: these drugs lead to grave health problems; legalization cannot prevent the use of new more dangerous drugs, and, finally, the legalization contradicts the major principles of sports.
Arguments supporting the statement that performance-enhancing substances legalization is impossible
Performance-enhancing substances cause long termed negative effects
Drugs legalization advocates admit that performance-enhancing substances use causes various side effects and grave health problems in athlete’s future lives. However, they also state that sport injuries can be also dangerous and performance-enhancing substances cause future health problems. For instance, according to Waddington cases of “osteoarthritis among retired footballers” are numerous and even “significantly greater than for the general population” (Waddington 28).
Waddington also claims that the risk of injuries in contact sport is also “very high” (28). Of course, it is impossible to deny that sport can lead to lots of injuries. Sometimes these injuries become even fatal, but any profession presupposes definite risks. For instance, such dangerous occupations like fire-fighters, miners, police officers and many others get injured every day.
However, it is possible to cure a broken leg or even arthritis in retired sports people, but it is hardly possible to cure the consequences of the performance-enhancing substances use. Thus, drugs use often leads to blood pressure diseases, aggression, insomnia, mental disorders, even hepatitis B and AIDS (if they share syringes), which are difficult to cure and some of these diseases are “irreversible” and incurable (Putnam 122).
Moreover, dozens of performance-enhancing substances users get involved in “rapes, traffic altercations, assaults, bar fights, and incidents of domestic violence” (Putnam 122). Thus, these drugs use not only affects negatively athlete’s health but it also leads to negative consequences in their personal and social lives as well. Thereby, it is necessary to stress that performance-enhancing substances cause serious health problems which cannot be juxtaposed with other professions injury risks.
Legalization will not lead to better control over drug use
Another argument for performance-enhancing substances legalization, which is the most common, is that drugs are still used even when they are banned. Thus, drugs legalization advocates claim that it is better to legalize some “not dangerous” drugs which could diminish or at least control the use of dangerous performance-enhancing substances. However, this argument is quite week. Admittedly, athletes often use drugs to improve their performances “without medical care” (Putnam 122).
Moreover, many athletes follow the simple rule “more is better” and “flood their bodies with many varieties of the drug” (Putnam 122). Thus, it is hardly possible to change the situation since even if some drugs can be available, people would always seek for better “medicine”. It is also necessary to take into account that legalized and new drugs can be taken simultaneously.
Of course, there will be no study of these substances interaction which may lead to serious health problems or even many deaths. Besides, even now many legal drugs are extremely dangerous, especially pain killers which may lead to cardiac disorders, and in “very large doses they cause central nervous system stimulation, convulsions and death” (Waddington 31).
Reportedly, painkillers act like energizers accumulating athletes’ energy which can be used to continue the game and show good performances (Putnam 122). However, these immediate energy accumulations are unnatural and very harmful since they cause many diseases and addictions. In fact, these legalized drugs are sometimes more dangerous than steroids and other performance-enhancing substances.
Thus, it is quite difficult to make a decision which drugs are not dangerous and which ones should be banned. Moreover, this partial (and total) legalization may lead to numerous abuses since pharmacological business can violate some ethical and medical issues of the problem and withhold some “inappropriate” information on negative consequences.
Doping tests are very useful for drug use prevention
One more argument to support performance-enhancing substances legalization is that doping tests, which are quite costly, lead to production of the less detectable drugs, rather than safer ones (Ashcroft 518). Moreover, Ashcroft et al. claim that doping test removal would lead to “less cheating, increased solidarity and respect between athletes, more focus on sport and not rules” (518).
First of all, it is simply impossible to remove doping tests since there will be constant need to check whether athletes take some new drugs. Besides, as has been mentioned above the drugs legalization will not stop production of new performance-enhancing substances which will be far from being safe. Admittedly, such substances are aimed at improving athletes’ performances. Here “inventors” follow the principle “if it does not kill you, it makes you stronger”.
In fact, doping tests are very useful not only for detecting drug use, but to prevent athletes from using performance-enhancing substances. Of course, many athletes do not use such substances since they want to be fair or simply do not need pharmacological enhancers, but many athletes think twice before using drugs for being afraid to be disqualified for performance-enhancing substances use.
Unfortunately, not only athletes try to use drugs. Many coaches and team doctors often make athletes use drugs, or sometimes they even do not say athletes what dangerous substances the latter take. So, if athletes are very concerned with their health, doctors may be less concerned with this issue. Thus, doping controls prevent coaches and team doctors from giving drugs to the athletes.
Performance-enhancing substances cause insignificant performance improvement but leads to considerable health risk
Another argument provided by drugs legalization advocates is that performance-enhancing substances do not lead to supernatural powers, but only improve physical performances, training capabilities and recovery processes and, thus, they can be legalized.
For instance, Waddington and Smith claim that drug use do not “improve one’s technical skill” so the performance gains” from performance-enhancing substances use are small (176). Thus, legalization supporters state that drug use is just another type of diet or medical care. According to Putnam, performance-enhancing substances can be in the one line with such “performance aids” as “computerized exercise programs, biomagnetic therapy” (126).
However, these very arguments only prove that performance-enhancing substances legalization is impossible since the benefits from drugs use are not significant, but risks of possible health problems are considerable. Therefore, there is no sense in making substances legal if they are harmful and cause no considerable improvements for athletes. Besides, the effects of performance-enhancing substances are not investigated thoroughly and some scientists even suggest that they may cause some genetic diseases.
It is also necessary to remember that sport and athletes inspire many young people. Reportedly, drug use in professional sport leads to the use of such substances in amateur sport which make many adolescents use performance-enhancing substances. For instance, Gold suggests that professional athletes should become “role models and spokesmen for drug-free sport and lifestyle” (14). Thus, performance-enhancing substances legalization will only increase the spread of drug use among adolescents.
Performance-enhancing substances cannot be considered as scientific progress
Finally, many legislation advocates suggest that performance-enhancing substances are indicators of human progress. They claim that sport and science should go hand in hand to reach higher results. However, it is impossible to ignore the fact that sport is the competition of human abilities, not chemicals. In fact, 20th century sport experienced such “drugs drive”. Thus, in the 1960-70s the effects of performance-enhancing substances were praised by drug users throughout media (Bahrke 8).
Interestingly, in the 20th century athletes did not pay attention to reports about various cases of deaths because of drug abuse and continued to use performance-enhancing substances. For instance, Bahrke quotes Ken Patera, U.S. weightlifter, who speaks about his Soviet rival:
Last year the only difference between me and him was I couldn’t afford his drug bill. Now I can. When I hit Munich I’ll weigh at about 340, or maybe 250. Then we’ll see which are better, his steroids or mine. (Bahrke 8)
Thus, it is clear that those times were the times when chemists competed not athletes. In fact, the ethical issue arises out of this argument about the “scientific approach” to training.
It is necessary to remember that any sport is a fair competition and demonstration of physical abilities and professional skills of athletes. Moreover, those scientific “improvements” lead to severe health problems so they cannot be regarded as the indicators of progress. Perhaps, someday scientists will invent some really harmless performance-enhancing substances.
Only after this it will be possible to start the conversation on the ethical issue of the problem trying to decide whether it is possible to launch some sport competitions of performance-enhancing substances users. At the moment the argument that scientific progress should support sports is groundless since, as has been stated above, it is impossible to mention scientific progress when enhancers do not improve performance but cause health problems.
Performance-enhancing substances legalization is impossible since drug use is too dangerous and provides no significant improvements
To conclude, it is possible to state that performance-enhancing substances cannot be legalized due to several facts. First of all, drug use is extremely dangerous for athletes’ health and their future lives.
Thus, arguments that sports are very dangerous and drugs are not the main risk factor is groundless since negative effects of performance-enhancing substances leads to very severe health problems when athletes retire. Secondly, drugs legalization will not stop these substances production and, vice versa, can lead to more dangerous drugs use with no medical control.
Thirdly, some drug legislation advocates presuppose the removal of doping tests. However, doping tests are helpful tolls of drug use prevention: being afraid of disqualification, many athletes avoid using drugs. Fourthly, performance-enhancing substances do not improve physical performances considerably, but instead they are very harmful for athletes’ health. Thus, drug use is not worth the risk. Finally, it is necessary to remember that sport is a competition of athletes’ abilities.
Moreover, one should admit that performance-enhancing substances cannot be regarded as scientific progress since they lead to various negative consequences and it is impossible to say that science only develops the abilities of a human body. Thus, it is not time to start discussion of the possibility of performance-enhancing substances legalization since these drugs not only violate the main principle of fair competition but cause numerous negative effects which are still insufficiently explored.
Works Cited
Ashcroft, R.E., Dawson, A., Draper, H. Principles of Health Care Ethics. London: John Wiley and Sons, 2007.
Bahrke, M.S. Performance-Enhancing Substances in Sport and Exercise. Champaign, IL: Human Kinetics, 2002.
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