Principles of Organizational Performance Management

Performance management is an important part of an organization because it can be used to help the organization understand how well it is accomplishing its goal of providing quality care. Performance management can also provide the organization with data that will be used to analyze changes that should be made in order to increase quality patient caregiving. The management can understand what is working, what needs improvement, and measures that can be done to improve and build on other successes. Performance management focuses on ways to improve patient outcomes through a better employee engagement. This can be accomplished through the use of a performance data scorecard that focuses on outcome measures within a specific healthcare organization. The purpose of this paper is to envision the roles and responsibilities in nurse leadership in analyzing a specific service section in a hospital. 

A. Performance Data Scorecard 

A1. Addressed Patient Population 

The population that is under investigation are the patients at the Surgical and Medical Floor at Inova Fairfax Hospital in Northern Virginia. Inova Fairfax Hospital (IFH) has a 923-bed capacity and provides several of the surgical and medical specialties in Northern Virginia. The hospital is also a major community hospital that offers a full spectrum of organ transplanting. Inova Fairfax has also been named among the top 50 hospitals that provides quality services in gynecology, heart surgery, and gynecology. The total number of inpatient surgeries was found to be 19,349, outpatient visits was found as 392,405, and emergency room visits was 98,317 (“Inova Fairfax Hospital”, 2019). The population identified will be addressed in the performance scorecard analysis. The specific age of the population in the assessment will be adults aged 18 years and older and individuals that have had surgical and post-surgical needs, illnesses that need specialized care, and other chronic medical conditions. 

A2. Outcome Measures 

The outcome measures that relate to the given population was divided as follows: 

Performance: It is expected that patients should have an improved satisfaction in the health care delivery. 

Quality: It is expected that there will be a timely administration of patient medication. 

Patient Safety: Improve compliance with hand-hygiene protocols throughout the medical/surgical department through evidence-based practice. 

Employee engagement: Better communication strategies among the staff. 

Measure	Outcome	Drivers
Performance – Improved patient satisfaction	Improve satisfaction scores of patients and decrease complaints from patients	- Follow-up calls and satisfaction surveys to receive feedback from patients and clients.  - Follow up on the negative surveys, feedback, and complaints and identify ways to improve on them.
Quality – Timely administration of medication	Patients should receive their medications on time (1 hour after or before the scheduled administration time)	- Minimize the risk of drug medication errors through wrong time, missed dose, and wrong frequency.  - Improve therapeutic levels and the effectiveness of administering medications.
Safety –  Improve compliance with hand-hygiene protocols	Make use of evidence-based practice to improve compliance with hand-hygiene protocols throughout the medical/surgical department	- Implement staff that observe hygiene.  - Supply multiple areas with hand sanitizers and sinks.  - Ensure hygiene protocols are met throughout the organization.
Engagement –  Better communication strategies	Better communication strategies among the staff	- Make use of evidence-based practice strategies to improve communication.  - Ensure collaboration among the staff to ensure harmony and a good workplace environment.

B. Processes That Drive Outcome Measures 

There are several processes that should be able to drive the outcome measures that were identified. The first process that can be used to drive patient satisfaction is to ensure that there are follow-up calls and surveys on patients and family members. The general surveys should be graded and a score given to the general facility and specific departments. Negative scores on the institution and specific department should be noted down and specific strategies to improve identified. 

Timely administration of medication will ensure that patients receive quality and timely care. Medication administration will be achieved by first collecting all the data regarding the patient’s treatment plan. The nurses in charge should be able to monitor dosage keenly. Timely administration of medication will ensure that the effectiveness of medicine is improved and drug medication errors will be minimized. The overall impact will be an improvement in the quality of care. 

Safety improvement will be achieved through a simple step of improving hand hygiene. Proper hand hygiene is set to create a positive ripple effect as it will minimize any spreading of disease. Measuring hand hygiene will be done through monitoring the staff and comparing the results with the national benchmark. 

Engagement of employees will be achieved through ensuring that there are better communication strategies among all the staff. Evidence-based practices can be implemented to further improve communication. Employees will be involved in various decision-making strategies. This will be measured through human resource data that deals with employee satisfaction surveys. 

B1. Additional Indicator 

The additional indicator that can be used by the nurse in order to drive the outcome measures would be the use of electronic health records (EHR). The records can be used to assess the medical history of the patient and result in an improvement in the overall safety of the patient. When making use of the EHRs, nurses should put down patient data immediately and not wait until their shift is over in order to document patient records. When using EHR, the nurse should be able to record any information when assessing or when talking to the patient. This can result in an improvement in communication between the nurse and the patient and the overall result would be a better patient outcome. The electronic health record of the patient will also play a crucial role in supporting interdisciplinary and collaborative approach in healthcare (Keller, Kelling, Cornelius, Oni, & Bright, 2015). Different individuals that deal with the patient should be able to monitor the patient data and monitor the progress of the patient. The records should also facilitate efficient communication among the nurses as it can highlight the treatment progress of the patient and any changes made in the treatment so that other nursing practitioners that deal with the patient. The HER should be able to provide adequate information on the patient and this ensures improvement in patient safety and the quality of care. 

C. Three Advantages of the Performance Data Scorecard 

The balance scorecard created has several advantages to the healthcare organization. The tool can be used as the basic foundational strategy that can drive the institution to achieve its mission, vision, and objectives. Some of the advantages of the performance data scorecard include improvement in organizational strategy, balanced performance, and collaboration. 

The main aim of the performance data scorecard is for the organization to identify its strategy and to enable it to achieve it. The scorecard is advantageous because it provides a visual form that can be used to drive the organization to achieving its strategy. Every member of the organization should be able to see the areas that need improvement. Everyone in the organization should be able to understand the overall strategy of the healthcare team. Department leaders will find it easy to engage in communication with their staff regarding achieving the objectives set in the scorecard. 

The other advantage of the scorecard is that it enables balanced performance of the healthcare organization. The scorecard makes use of multiple measures that can be used to make improvement in different areas of the institution. The specific critical areas that are addressed such as the quality of care, patient safety, engagement and staff involvement, and an overall performance of the organization (Graban, 2018). Improving on the multiple areas of the organization ensures that organizational goals will be met. In a practical setting, the organizational goals are dependent on one other and a balanced improvement of performance ensures that there is an overall improvement in organizational goals. 

The scorecard will also facilitate collaboration among the healthcare team. Team members should be able to focus on helping each other to succeed and there will be better communication lines and strategies. One of the central factors of the scorecard is employee engagement which is a drive for the staff to collaborate with their leaders. Additionally, all team members will find it easy to work together as they will be working towards a common strategy identified through the scorecard. 

D. Current Trends of Employee Engagement in Healthcare 

Employee engagement is a critical factor that has become highly important in the healthcare industry. Employees are increasingly becoming an important part of the institution and there are several new trends emerging that can be used to improve employee engagement. One of the current trends with employee engagement is continuous feedback. Continuous feedback is a recent trend where employees receive regular reports that can show their rights and wrongs and how they can improve (Kumar & Pansari, 2016). The practice enables nursing practitioners to improve their self-awareness and to be able to improve on their wrongs. One of the ways to provide feedback in the recent past has been through employee rounding. Employee rounding is a trend where the leader can speak to employees as a group. Employee rounding is different from continuous feedback since continuous feedback is more personalized and separates a particular worker from the rest of the group. 

Leadership practices have also moved from traditional practices. Current practices in leadership observes that leaders should move away from authoritative leadership. Leaders today have to show that their employees are valued and should readily welcome their opinions. Leaders today have to be transformational and not simply manage and direct (Nguyen, Mia, Winata, & Chong, 2017). They should ensure that they keep employees active and participate with employees in the decision making process. Democratic forms of leadership have to be implemented where employees have a voice and encouraged to be part of the changes in the department and take part in the daily activities that can be used to realize departmental goals. The leadership practices have changed and the department and organizational leaders should change their leadership style in order to accommodate the new group of employees. 

D1. How Employee Engagement Improves Healthcare Quality 

Employee engagement can be used to facilitate an improvement in healthcare quality in different ways. Employee engagement ensures that employees are engaged in the organization and its goals. An organization that has its goals of improvement patient safety and quality of care will have its employees working towards realizing better outcomes. Engaged employees should thus participate in the vision of the organization and will be promoters of process improvements of the organization. When some of the processes fail, they will not quit but will be ready to engage better ways to better realize the outcomes (Wang, Zhang, Thomas, Yu, & Spitzmueller, 2017). Employees that are not engaged will not play a central in the organizational goals and there will be consistent issues of low quality work and increased turnover. 

Employee engagement also creates a positive attitude among employees and enables them to transfer the attitude to their patients. The caregiver and patient relationship will improve and the overall result will be positive patient outcomes. Healthcare quality is highly dependent on the attitudes, feeling, and thoughts of the individuals that provide care (Read & Laschinger, 2015). An engaged employee will have a job satisfaction and positive feelings regarding the organization and the result is better level of care. Employees that are engaged also become better advocates for patients. They will take a crucial role in facilitating the organization to set up systems that improve patient outcomes. An employee that is disengaged will have a bad attitude towards their employer. The bad attitude will be prevalent through the engagement of the employee with the patients. 

D2. Tools to Provide Data Regarding Employee Engagement 

The institution under study is Inova Fairfax Hospital. The institution currently makes use of employee engagement and employee satisfaction surveys. The employee engagement survey is usually completed after every six months. The data regarding the survey is collected and then evaluated by the human resource team. The results received are later shared to different managers in specific department. The results are used to inform specific challenges and performance of a department and highlight changes that need to be implemented. 

Leaders are provided with a departmental breakdown of the surveys with tools that can be used to interpret the given report. For instance, my departmental unit received high marks regarding high engagement. It also showed that employees were not given enough opportunities that could be used to further their education. In order to address the specific issue, the leaders decided to have someone that could send weekly emails regarding various educational opportunities available. 

E. Plan to Improve Employee Engagement 

Improving employee engagement can be achieved through the use of a series of steps and strategies. The first strategy is to have the right surveys on employee engagement. Healthcare organizations can have a poor assessment of their engagement as a result of a poor employment engagement survey. This is usually caused by having the employee survey which focuses on collecting data that may be irrelevant and impossible (Bin, 2015). In order to correct the data, organizations should strive to ensure that the data provided is geared towards collecting relevant, actionable, and specific data. The data collected should later be applied in order to improve critical performance metrics. 

The second strategy to improve employee engagement is to have adequate leadership that supports open communication and employee recognition. Leaders should be able to readily communicate with the employees regarding any issues pertaining the workplace. The leader should also communicate a clear vision of the organization and strive to abide by the organizational goals and mission. The leader should also engage in employee recognition initiatives which can be realized through the use of rewards and bonuses. Positive recognition should be provided and follow-up on various employees made in case they have challenges. Successful leadership will involve taking information from the employees and providing effective feedback that can be used to facilitate team effort. 

The third strategy will involve having an organizational culture that focuses employee engagement. The strategy will involve new employees undergoing an orientation by meeting with nurse leaders and various individuals within their department. The individual will then undergo cultural training that highlights the importance of engagement. An open door policy will also be implemented to ensure that there is a general cultural climate that focuses on open communication. The manager’s office or the office of various leaders will be made in a way that shows that it is a safe zone where employees can highlight their challenges and problems without judgment (Tapping & Shuker, 2018). 

E1. Leadership Practices to Facilitate Employee Engagement 

There are several leadership strategies that can be used to facilitate the process of employee engagement. The first practice involves the creation and communication of organizational mission, vision, and goals. Employees that understand the strategic position of the organization will be committed to the organization and vested in its success. They will be eager to take part in improving the strategy through sharing of ideas, discussing practices that can be used to achieve the vision of the organization, and monitoring the progress of realizing the goals. 

Adequate communication strategies should also be implemented in order to give employees a voice. Communication may be achieved through the use of surveys, email communication, social media communication, or staff meetings. Such a platform should provide employees with a platform where they can share ideas regarding goals and values of the organization. 

The leadership will also encourage effectiveness and innovation of employees through the use of a series of strategies. The leader will listen to the point of view of employees, ask for feedback, and giving employees a chance regarding how they want to do their job. The leader will encourage innovation by recognizing good work in a way that matters to the employees and encouraging employees to undertake new approaches and risks. 

The leadership will be involved in the decision-making of the employees’ personal mission and goals. Employees will be given an opportunity to discuss both their future and the company’s future with the leadership. Any decisions made by employees will be supported by the leaders. Above all employees will be treated with dignity and respect and the leadership will follow through with the commitments and promises made to employees. 

The leadership can also make use of formal rewards and recognition programs to appreciate employees and ensure their engagement. Employees that have their accomplishments recognized will engage better in the organization goals. In case employees make mistakes, they will be able to sit with the leadership and discuss the lessons they could take from a specific situation. 

Conclusion 

Employee engagement is a critical part of the organization that can be achieved through several processes such as the use of a performance scorecard, leadership practices, and other supporting nursing tools. The performance scorecard can be used to focus on outcome measures that improve performance, quality, patient safety, and employee engagement. For the given healthcare organization, process improvement will be possible through focusing on patient satisfaction, timely medication, improved hand protocols, and better communication strategies. Proper leadership lies at the center of improving employee engagement. Proper communication and involving employees in formulating organizational mission and goals should be used to facilitate employee engagement. 

References 

Bin, A. (2015). The relationship between job satisfaction, job performance and employee engagement: An explorative study.  Issues in Business Management and Economics ,  4 (1), 1-8. 

Graban, M. (2018).  Lean hospitals: improving quality, patient safety, and employee engagement . Productivity Press. 

Inova Fairfax Hospital. (2019). Retrieved from https://www.revolvy.com/page/Inova-Fairfax-Hospital . 

Keller, M. E., Kelling, S. E., Cornelius, D. C., Oni, H. A., & Bright, D. R. (2015). Enhancing practice efficiency and patient care by sharing electronic health records.  Perspectives in health information management ,  12 (Fall). 

Kumar, V., & Pansari, A. (2016). Competitive advantage through engagement.  Journal of Marketing Research ,  53 (4), 497-514. 

Nguyen, T. T., Mia, L., Winata, L., & Chong, V. K. (2017). Effect of transformational-leadership style and management control system on managerial performance.  Journal of Business Research ,  70 , 202-213. 

Read, E. A., & Laschinger, H. K. (2015). The influence of authentic leadership and empowerment on nurses’ relational social capital, mental health and job satisfaction over the first year of practice.  Journal of Advanced Nursing ,  71 (7), 1611-1623. 

Tapping, D., & Shuker, T. (2018).  Value Stream Management for the Lean Office: Eight Steps to Planning, Mapping, & Sustaining Lean Improvements in Administrative Areas . Productivity Press. 

Wang, Z., Zhang, J., Thomas, C. L., Yu, J., & Spitzmueller, C. (2017). Explaining benefits of employee proactive personality: The role of engagement, team proactivity composition and perceived organizational support.  Journal of Vocational Behavior ,  101 , 90-103.