86 unit 2 | Working Within the Organization
opportunities to identify needs for further orientation
or extended training (Hayes, 2002; Lombardi, 2001).
Six months later, the staff nurse and nurse manager
sit down again and evaluate the staff nurse’s perfor-
mance in terms of the previously set goals. The evalu-
ation is based on the staff nurse’s self-evaluation and
the nurse manager’s observation of specific behaviors.
New objectives for the next 6 months and plans for
achieving them may be agreed on at the time of the
appraisal or at a separate meeting (Beer, 1981). A
copy of the performance appraisal and the new goals
must be available to employees so that they can refer
to them and check on their progress.
It is important to set aside adequate time for
feedback and goal-setting processes. Both the staff
nurse and the nurse manager bring data for use at
this session. These data include a self-evaluation by
the staff nurse and observations by the evaluator of
the employee’s activities and their outcomes. Data
may also be obtained from peers and patients.
Some organizations use surveys for getting this
information from patients.
Most of the guidelines for providing evaluative
feedback discussed earlier apply to the conduct of
performance appraisals. Although not as frequent
or immediate as informal feedback, formal evalua-
tion should be just as objective, private, skillfully
communicated, and growth-promoting.
Standards for Evaluation
Unfortunately, many organizations’ employee eval-
uation procedures are far from ideal. Such proce-
dures may be inconsistent, subjective, and even
unknown to the employee in some cases. The fol-
lowing is a list of standards for a fair and objective
employee evaluation procedure that you can use to
judge your employer’s procedures:
■Standards are clear, objective, and known in
advance.
■Criteria for pay raises and promotions are clearly
spelled out and uniformly applied.
■Conditions under which employment may be
terminated are known.
■Appraisals are part of the employee’s perma-
nent record and have space for employee
comments.
■Employees may inspect their own personnel file.
■Employees may request and be given a reason-
able explanation of any rating and may appeal
the rating if they do not agree with it.
■Employees are given a reasonable amount of
time to correct any serious deficiencies before
other action is taken, unless the safety of self or
others is immediately threatened.
In some organizations, collective bargaining agree-
ments are used to enforce adherence to fair and
objective performance appraisals. However, collec-
tive bargaining agreements may emphasize senior-
ity (length of service) over merit, a situation that
does not promote growth or change.Peer Review
Peer reviewis the evaluation of an individual’s prac-
tice by his or her colleagues (peers) who have similar
education, experience, and occupational status. Its
purpose is to provide the individual with feedback
from those who are best acquainted with the
requirements and demands of that individual’s posi-
tion: colleagues. Peer review is directed to both
actions(process) and the outcomesof actions. It also
encompasses decision making (critical thinking) and
technical and interpersonal skills (Mustard, 2002).
Professionals frequently observe and judge their
colleagues’ performance. However, many feel
uncomfortable telling colleagues directly what they
think of their performance, so they do not indicate
their thoughts unless informal feedback is shared
regularly or a formal system of peer review is estab-
lished (Katzenbach & Smith, 2003). Whenever
staff members meet to audit records or otherwise
evaluate the quality of care they have given, they are
engaging in a kind of peer review.
Formal peer review programs are often one of
the last formal evaluation procedures to be imple-
mented in a health-care organization. They
increase the number of sources of feedback and
contribute to a rich, comprehensive evaluation
process (Guthrie & King, 2004).Fundamentals of Peer Review
There are many possible variations of the peer
review process. The observations may be shared
only with the person being reviewed, with the per-
son’s supervisor, or with a review committee. The
evaluation report may be written by the reviewer, or
it may come from the review committee. The use of
a committee defeats the purpose of peer review if
the committee members are not truly peers of the
individual being reviewed.