MMHA 5500 Week 7 Performance Appraisal Design Paper Example

Appraisal Design: Behavior-Based Reviews for Surgical Technologists Across the Lakeside Network

Student Name

Walden University

MMHA 5500: Human Resource Management and Organizational Development and Leadership for Healthcare Administrators

Instructor Name

Month Day, Year

Appraisal Design: Behavior-Based Reviews for Surgical Technologists Across the Lakeside Network

The Problem

Surgical technologists across the composite Lakeside Outpatient Network disputed their last annual reviews, and their complaint was fair. The form asked supervisors to rate each technologist on broad traits such as teamwork, professionalism and initiative, using a five-point scale from unsatisfactory to outstanding. Several technologists received ratings of meets expectations for teamwork that could not be traced to anything a supervisor had observed, and two received lower ratings than peers who, by the technologists' own account, did the same work. Required certifications and annual competency checks were also rated on the same scale, so a technologist with a current certification could receive anything from a three to a five. The redesign answers each problem.

Part One: Requirements Met or Unmet

Part one lists requirements that are met or unmet rather than rated: current certification where the center requires it; annual competency validations, such as sterilization and instrument handling; and mandatory education, such as fire safety and infection control. A technologist who has met them all meets part one; one who has not is given a date to do so. None of these items affects the rated section. Mixing them with judgments of performance, as the old form did, made both meaningless: it rewarded paperwork as if it were performance and allowed a current certification to be rated differently for different people.

Part Two: Rated Dimensions

Part two rates five dimensions drawn from what surgical technologists actually do: instrument and count accuracy; sterile field maintenance; case readiness, meaning instruments, supplies and the room prepared before the case starts; efficiency during room turnover; and communication during the surgical time-out and the case. Each is rated on a behaviorally anchored rating scale.

Behaviorally Anchored Scales

Behaviorally anchored rating scales were developed so that each point on a scale is tied to a description of observable behavior, written and checked by people who know the job, rather than to an abstract label (Smith & Kendall, 1963). Table 1 shows the anchors for one dimension. The others follow the same pattern.

Table 1

Anchors for Instrument and Count Accuracy

Evidence Sources

Each dimension names the evidence a supervisor should use. Count accuracy draws on the count discrepancy log, which records who identified each discrepancy. Sterile field maintenance draws on the infection prevention nurse's observation audits. Case readiness draws on the first-case start log and delay codes. Turnover efficiency draws on room turnover logs. Communication draws on time-out audits and, where available, structured feedback from circulating nurses and surgeons. A rating that cannot be traced to at least one of these sources is not entered. This rule answers the original complaint directly: no rating without something observed.

Calibration Before Release

Before ratings are released, the supervisors across the network's sites meet to calibrate. Each supervisor brings draft ratings and the evidence behind them. The group compares ratings for technologists in similar roles, looks for supervisors who rate consistently high or low and asks for evidence where a rating seems out of line with the anchors. Calibration does not force a distribution; it makes supervisors justify differences. Research on performance appraisal has long found that rater differences and rating errors limit the accuracy of appraisals, and that the purpose and context of appraisal shape how raters behave (DeNisi & Murphy, 2017). Calibration is a practical answer to both.

Building the Anchors With Technologists

The anchors are not written by supervisors alone. Smith and Kendall's original method had people who know the job generate examples of effective and ineffective behavior and then sort them into dimensions and levels, keeping only examples on which raters agreed (Smith & Kendall, 1963). The redesign follows that approach. A working group of four technologists from different sites and two supervisors drafts examples for each dimension. A second group of technologists, who did not write them, sorts the examples into dimensions and levels. Examples that the two groups place differently are rewritten or dropped. Involving technologists this way serves two purposes: it produces anchors that describe real work, and it gives the people who disputed the last reviews a hand in building the new ones.

Rolling Out the New Form

Supervisors will receive two hours of training before the first cycle, using sample evidence files to practice rating each dimension and comparing results. A midyear check-in, using the same dimensions and anchors but with no formal rating, lets technologists see how their work maps to the anchors months before the annual review. This also gives the feedback that job design research identifies as a source of motivation, information about how well one is performing (Hackman & Oldham, 1976). Technologists will receive the dimensions, anchors and evidence sources in writing at the start of the cycle, so nothing in the review is a surprise. Supervisors new to the network will complete the same training before rating anyone.

What the Design Does Not Do

The design does not tie ratings mechanically to pay increases, which the collective agreement sets by seniority, and it does not replace coaching during the year, which supervisors should give when they see behavior worth recognizing or correcting. DeNisi and Murphy argue that improving the appraisal form matters less than improving how performance is managed day to day (DeNisi & Murphy, 2017), and the design is meant to support that work, not substitute for it. It will be judged by the number of reviews disputed in the next cycle, and by technologists' responses to one question added to the review: whether the rating was explained with examples they recognized.

References

DeNisi, A. S., & Murphy, K. R. (2017). Performance appraisal and performance management: 100 years of progress? Journal of Applied Psychology, 102(3), 421-433. https://doi.org/10.1037/apl0000085

Hackman, J. R., & Oldham, G. R. (1976). Motivation through the design of work: Test of a theory. Organizational Behavior and Human Performance, 16(2), 250-279. https://doi.org/10.1016/0030-5073(76)90016-7

Smith, P. C., & Kendall, L. M. (1963). Retranslation of expectations: An approach to the construction of unambiguous anchors for rating scales. Journal of Applied Psychology, 47(2), 149-155. https://doi.org/10.1037/h0047060