Self Evaluation - Michigan Medicine



UNIVERSITY OF MICHIGAN HEALTH SYSTEMPerformance Evaluation Process-Self-evaluation with Peer InputThe process of annual evaluation is a professional and contractual obligation. All parties are accountable for following this process and ensuring timely review. The evaluation process is supportive of professional growth and development of all parties to ensure quality patient care and optimal outcomes.5274310405765Target Audience: Nursing at Michigan | Author/Contact: Mark Kempton | Last reviewed: August 201700Target Audience: Nursing at Michigan | Author/Contact: Mark Kempton | Last reviewed: August 2017Upon receiving notification of the annual evaluation, the employee has three weeks to complete the self-evaluation (including peer feedback) process. The self-evaluation is to be submitted electronically to the manager/designee after including a summary of the peer feedback received. If materials are not submitted within two weeks of the due date, the manager may proceed with completing the evaluation process. Peer Review ProcessThe nurse will select and request a minimum of 3 peers to perform peer review.Those selected must be educated in the peer review process. At least one peer must be an RN. Each nurse will be asked to evaluate the person on 1-2 selected domains, so that all Role Specific domains are reviewed by peers.The RN will send the peers the feedback tool electronically, identifying the specific domain(s) for completion. The Clinical Skills and Judgment domain must be completed by an RN.The peers selected will use the current Peer Input tool for the RN requesting their feedback. They will complete the feedback tool:Peers should indicate the appropriate behavioral level. Peer reviewers would be encouraged to support their views with concrete examples on the right hand side of the page.Peers should return the completed feedback electronically to the nurse being evaluated and to the manager/designee within 7 days Self-Evaluation ProcessThe nurse will complete the level (A, C, D, E, RSAM) appropriate self-evaluation and submit electronically to the manager or designee. The nurse will consider the input provided by the peer evaluation(s) when completing their self-evaluation and will summarize the peer feedback on the performance review form in the Required Feedback Section. Supportive responses for behaviors will be included in the summary section(s). Manager ProcessThe manager will review the peer review form, peer summary and self-evaluation and then complete the manager section of the evaluation form within the anniversary month of the nurse.The manager will utilize peer and self-evaluations as well as own knowledge of employee performance in determining ratings on the Performance Planning and Evaluation form.Supportive responses for behaviors will be included in the summary section(s) including rational for other than “meets expectations”. Arrange an appointment to meet with the nurse.Sending the completed evaluation to the nurse electronically for review prior to the meeting will allow conversation to be focused on goals. Note: Any area of the evaluation the employee or manager would like to discuss more in-depth will also occur during the meeting.The Peer Review forms will be returned to the nurse as well as kept with the completed evaluation paperwork following the performance evaluation process and a copy of the completed Performance Plan/Evaluation will be given to the nurse.Education Nurse Coordinator Expert LevelScale: N = Behavioral Expectations Not Met or N/A A = Approaching Behavioral Expectations M = Meets Behavioral Expectations E = Exceeds Behavioral ExpectationsSelf EvaluationManager’s EvaluationUMHHC Performance Expectations For All Employees (Click for Framework Domain Behavior Descriptions)Customer Focus: Relates work and job purpose to UMHHC mission and commitment to putting patients and families first. FORMTEXT ????? FORMTEXT ?????Teamwork: Interacts effectively and builds respectful relationships within and between units and among individuals. FORMTEXT ????? FORMTEXT ?????Communication: Communicates effectively in ways that enhance productivity and build respectful relationships. Demonstrates active listening, written, verbal, and information technology skills. Shares relevant information. FORMTEXT ????? FORMTEXT ?????Conflict Resolution: Seeks constructive approaches to resolving workplace issues. FORMTEXT ????? FORMTEXT ?????Integrity: Adheres to high standards of personal and professional conduct. FORMTEXT ????? FORMTEXT ?????Adapting to Change: Responds positively to change, showing willingness to learn new ways to accomplish work. FORMTEXT ????? FORMTEXT ?????Respect for Individuals: Fosters mutual respect and supports UMHS commitment to diversity. Promotes community building and diversity initiatives that help employees learn and respect each others’ differences. FORMTEXT ????? FORMTEXT ?????Safety: Contributes to a safe and secure environment for patients, visitors, faculty, and staff by following established procedures and protocols as appropriate by job function. FORMTEXT ????? FORMTEXT ?????Quality: Adopts practices to improve work processes, enhance customer satisfaction and ensure excellence in daily work. FORMTEXT ????? FORMTEXT ?????Efficiency: Accomplishes work in ways that maximize productivity and available resources while minimizing waste. FORMTEXT ????? FORMTEXT ?????Attendance. FORMTEXT ????? FORMTEXT ?????Summary of UMHHC Performance Behaviors (Includes supporting comments and areas requiring further development. Use corresponding number where applicable.)Self:Manager:CLINICAL THINKING AND JUDGMENT50292013335000rATINGS FORMTEXT ????? FORMTEXT ?????Can develop assessment tools in collaboration with others to measure individual and group learning needs.Recognizes the relative importance and increasingly able to prioritize learning needs.Differentiates between learning needs and non-learning needs.Plans and designs learning interventions in collaboration with other leaders.Updates and revises plans targeting specific needs.Functions independently in planning and design of learning interventions.Implements teaching/learning for entire unit and begin to extend beyond unit boundaries.Collaborates on CE development and process.Evaluates outcomes in terms of instructional objectives and learning needs.Evaluates outcomes relative to unit strategic plans.Develops evaluation tools utilizing resources and literature.Demonstrates proficient clinical practice.Is intuitive in familiar situations.Solves problems reliably, utilizing resources.Plans proactively for both immediate and long term educational needs.oPTIONAL SUPPORTIVE COMMENTS:SYSTEMS THINKING50292011557000rATINGS FORMTEXT ????? FORMTEXT ?????Recognizes the interrelationships that exist across our system.Incorporates organizational mission, vision, and values in educational planning and processes.Assumes leadership in unit/area Professional Practice Model.Develops strategies for the implementation of necessary municates requirements for change and assists with evaluation phase.Adapts systems to accomplish educational goals/objectives.oPTIONAL SUPPORTIVE COMMENTS:ADVOCACY50292011557000rATINGS FORMTEXT ????? FORMTEXT ?????Advocates for the collective needs of learners, preceptors, and managers.Assists in the development of nurse’s advocacy and moral agency through teaching, coaching, role modeling, and/or mentoring.Serves as an agent for learners and professional nursing educational issues.oPTIONAL SUPPORTIVE COMMENTS:THERAPEUTIC RELATIONSHIPS/ENGAGEMENTrATINGS FORMTEXT ????? FORMTEXT ?????Assumes leadership role and works with others to maintain a supportive environment for learning.Values individual talents, strengths, and skills of all staff, new and experienced.oPTIONAL SUPPORTIVE COMMENTS:COLLABERATION/COMMUNICATION, and PROFESSIONAL RELATIONSHIPSrATINGS FORMTEXT ????? FORMTEXT ?????Collaborates with learners, preceptors, educators, and managers/directors to ensure that instructional and/or educational processes are congruent with the standards of excellence.Promotes positive, constructive, confidential, professional relationships in others.Collaborates with schools of nursing and other departments to ensure mutual benefits for educational purposes.Creates and supports a learning environment that is characterized by safe discourse, constructive feedback, conflict resolution, and first party communication.oPTIONAL SUPPORTIVE COMMENTS:FACILITATOR of LEARNING and PROFESSIONAL DEVELOPMENTrATINGS FORMTEXT ????? FORMTEXT ?????Demonstrate computer skills in relation to teaching: learning environments.Demonstrates proficiency in the utilization of the electronic learning management systems.Applies competency based approaches to nursing education and development: + curricula that support lifelong learning, evidence based practice, and professional accountability.Develops instructional objectives in the cognitive and psychomotor domains.Applies developmental principals (Novice to Expert) to design and implementation of educational programming.Identifies opportunities for staff to enhance their professional growth within the unit/area.Sets goals on an ongoing basis to enhance development in the nurse educator role.Beginning evidence of advancing professional identity: Membership in a professional organization.Familiarity with literature in education and/or clinical specialty.Presents at educational programs within the unit/area and institution.OPTIONAL SUPPORTIVE COMMENTS:RESPONSE (responsiveness; sensitivity) to DIVERSITYrATINGS FORMTEXT ????? FORMTEXT ?????Modifies and utilizes a variety of teaching methods to meet identified learner needs and learning style.Creatively removes or minimizes barriers.Participates in the promotion of an environment that embraces diversity in the workplace.OPTIONAL SUPPORTIVE COMMENTS:ADVANCING PRACTICE50292011557000rATINGS FORMTEXT ????? FORMTEXT ?????Incorporates pertinent nursing, patient care, and/or educational research into educational programs and materials.Takes on leadership role in relation to innovations/improvements in educational initiatives.Implements change in educational programs based on application of current research findings.Incorporates research into program and materials.Applies performance improvement (i.e.: PDCA, LEAN Process, etc.) principles in the process of continuously enhancing educational programming.oPTIONAL SUPPORTIVE COMMENTS:CONTRIBUTION (see bolded behaviors throughout the document – these reflect contribution domain)rATINGS FORMTEXT ????? FORMTEXT ?????See BOLDED behaviors imbedded in other domains.oPTIONAL SUPPORTIVE COMMENTS:COORDINATION (of education)rATINGS FORMTEXT ????? FORMTEXT ?????Collaborates with others to coordinate educational activities.oPTIONAL SUPPORTIVE COMMENTS:Overall Summary of UMHHC Performance Expectations and Individual Framework Domains: Identify the individual areas of strengths and opportunities for improvement within the domains (Includes supporting comments and areas requiring further development) Self:Manager:Previous Year’s Learning and Self-Development Plan Assessment. Sources: M-Learning system transcript and other sources for specific courses and activities completed towards goal achievement and or professional growth and development. , List supporting comments and areas requiring further development below. Include last year’s evaluation petency / Mandatory Requirement Summary – See M-Learning link to obtain transcript. Required mandatories include Fire/Safety, Corporate Compliance, Unit Critical Incident Plan, and Patient Safety. Refer to blue folder competency tab for competencies not included in M-Learning.REQUIRED FEEDBACKUMHS Peer Feedback tool – all 5 domains (Clinical Skills and Knowledge domain must be completed by RN), a minimum of 3 – Refer to instructions Additional sources of peer/customer feedback may include:Patient satisfaction survey results360 Feedback resultsEmployee Recognition received e.g. Making a DifferenceWritten feedback (i.e. emails) regarding the individuals performanceEmployee’s Summary of feedback received:Annual Plan; The Learning, Self-Development and Improvement Plan is used to set personal and professional goals which contribute to the staff member’s growth and development. Time frames should be stated with all staff development goals.1. Growth Area:Time FrameOutcome:Action:Evaluation:Comments:2. Growth Area:Time FrameOutcome:Action:Evaluation:Comments:3. Growth Area:Time FrameOutcome:Action:Evaluation:Comments:Employee Comments: (Optional)Overall Evaluation Summary Statement-ManagerGuidelines for the overall performance ratings go to (form must be unlocked to use links) Overall Performance RatingNAMEScale: N = Behavioral Expectations Not Met or N/A A = Approaching Behavioral Expectations; M = Meets Behavioral Expectations; E = Exceeds Behavioral Expectations FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX If “N” or “A” used in the overall rating, check problem area(s) listed below. Identify any action plans for UMHHC performance expectations, job specific, or self development areas not listed above. FORMCHECKBOX Job Specific FORMCHECKBOX Customer Service FORMCHECKBOX Communication FORMCHECKBOX Effective team / group work FORMCHECKBOX Other: FORMTEXT ?????Action Plan: DateEmployee’s SignatureDateSupervisor/Manager NameSupervisor/Manager SignatureDepartment Code of Conduct Attestation Located in M-Learning ................
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