Evaluation of staff in Healthcare Companies

INTRODUCTION

Evaluation is a complex process that requires specific, targeted, valid and relevant tools in the analysis of the individual characteristics and skills of those who are assessed. It also explores   the potential skills of people, allowing you to build a map of a future development. The evaluation of the personnel is important not only for the remuneration of the managers’ results and for the productivity of the employees, but also for its use within a classification and career system built on horizontal economic progressions. The term evaluation also covers other aspects: enhancement of human resources, improvement of the performance, identification of the potential that is present in the structure and the specification of the body’s objectives.  Evaluation can be divided into four phases:

• organize a qualitative or quantitative assessment, based on criteria, indicators and standards;
• measure the indicators;
• compare criteria and indicators with standards;
• formulate, after a correct analysis, a judgment of merit.

MATERIALS AND METHODS

Staff evaluation finds its raison d’etre, even in multiple standards. The most significant references are:

• the Presidential Decree 10/01/1957 n. 3, in which art. 10,
• the Presidential Decree 20/12/1979 art. 14
• the Legislative Decree 502/92 to art. 10
• the Legislative Decree 29/93 to art. 17
• the C.C.N.L. of the health sector 1998/2001 art. 16 paragraph 2 and 4, art. 21 paragraph 4/5/6/7
• the Legislative Decree No. 150 of 27 October 2009 (Brunetta reform).
• the Legislative Decree 25 May 2017, n. 74

Among these decrees, the most significant and with the greatest impact one is certainly the Legislative Decree of 27 October 2009, no. 150, known as “Brunetta law”. This law makes evaluation one of the fundamental pillars in the public employment reform process.  It has also codified and defined the measurement and evaluation system in public administrations providing that each PA is required to measure and evaluate performances with reference to the administration as a whole, to the organizational

units or areas of responsibility in which the organization is divided and to the individual employee, through a system of transparent indicators and specific and measurable objectives.

Healthcare is part of the public administration system and the Legislative Decree 150/09 reiterates, among other things, the need to put in place objective evaluation systems aimed at measuring organizational and individual performance.

This decree regulated the employment relationship of public administration employees by intervening on:

• collective bargaining;
• assessment of the structures and personnel of public administrations;
• enhancement of merit;
• promotion of equal opportunities;
• public leadership;
• disciplinary responsibility.

The provisions of this decree ensure:

• better organization of work;
• respect for the areas reserved respectively for the law and collective bargaining;
• high quality and economic standards of functions and services;
• incentives for the quality of work performance;
• recognition of merits and demerits;
• selectivity and enhancement of skills and results for managerial positions;
• strengthening the autonomy, powers and responsibilities of management;
• the increase in the efficiency of public work and the contrast to low productivity and absenteeism;
• transparency of the work of public administrations also to guarantee legality.

The Brunetta reform provides for some reward systems:

• the annual bonus of excellences;
• the annual innovation prize;
• economic progressions
• career progression;
• the assignment of tasks and responsibilities;
• access to higher education and professional growth paths.

The integrated personnel evaluation system evaluates the contribution of each human resource in terms of:

• evaluation of positions:  a  set of activities and responsibilities with respect to a particular organizational level;
• performance evaluation: a  set of behaviors by which an individual achieves predefined and communicated objectives, which have been placed within his role;
• assessment of potential: a set of skills  an individual is not yet used to because they are not required by the role they are holding;
• Position evaluation assesses the skills required to fill a certain position.

It is carried out using some specific tools:

• Job analysis;
• Job description;
• Job specifications;
• Job evaluation.

The performance assessment assesses the knowledge and skills of the worker. Therefore, the subject of the evaluation are:

• Facts that have happened;
• Achieved Results;
• •Implemented Behaviors ;
• Activities that are carried out.

The evaluation of the potential currency allows to know the human resources present in the Healthcare Organization to meet organizational needs in the short-medium term (2-5 years).

Potential assessment is a means of:

• Company investment to grow its employees;
• Planning;
• Staff enhancement and motivation;

The evaluation cycle has an annual frequency and will be divided into three fundamental moments:

1. Planning;
2. Monitoring;
3. Final evaluation.

Planning takes the form of the   awareness of the assessed behavior and performance expectations. The objectives will have to be spelled out ex ante and shared. The monitoring involves a formal midway  interview  through the evaluation cycle to verify the achievement of the objectives. It is essential to establish a feedback relationship between the assessed and the assessor with reference to the activities carried out. The final evaluation will take place at the end of the year and also allows the identification of the objectives for the following year.

The main technical elements for the evaluation are:

• the evaluation manual;
• the evaluation sheets;
• the evaluation interview.

The evaluation manual (art.6 Ccnl of 31/1/1999) is a synthetic guide for the use of the evaluators, prepared by the Director and / or by the Evaluation Unit, which illustrates the purposes, methodology and evaluation tools. In particular, it is good to disseminate a schematic list of the various steps, in order to ensure that the assessment process is carried out with the necessary homogeneity, timeliness and completeness. The individual evaluation form can be constructed in different ways for the different categories. It is the tool that documents the evaluation process. It usually consists of two sections: the first contains the personal data of the assessed and the company data (position, sector of belonging, serial number, period of time to which the assessment refers). In the second there is the actual evaluation, with the object of the evaluation, the scoring scale and the spaces for partial and total scores. The interview, if well managed and conducted, can fulfill a function of strengthening the evaluation process. It represents the final moment of the evaluation cycle and has the aim of returning feedback on the performance of the assessed person, based on the observation of his activities, therefore focusing on his work and not on the person. During the interview, the assessor will be able to offer further ideas and reflections to the assessed in order to activate him in the construction of a growth path suitable not only for the critical issues or gaps found, but also realistic with respect to his resources and motivations. In each interview, the evaluator is called to guarantee:

• a punctual ex-ante preparation, analyzing carefully and in depth the different evaluation dimensions;
• comments supported by clear and specific examples;
• the creation of an adequate context, avoiding any type of interruption;
• a positive attitude and respect for the interlocutor, aimed at creating a climate of mutual trust, showing interest in what the assessed person has to say;
• a strong orientation towards listening so as to understand the interlocutor’s points of view, avoiding a judgmental approach and preferring a constructive attitude.

Conversely, the evaluation interview, if managed with low professionalism, can produce negative effects such as:

• the delegitimization of the assessor in the eyes of the assessed;
• the delegitimization of the entire evaluation system.

CONCLUSION

In conclusion, it can be said that the development of an effective evaluation system cannot be separated from  the change in the basic culture of work organization that enhances staff policies in all its aspects,  as well as  from attention to training, to motivation, to team work, sharing programs and objectives that aim to satisfy the communities of reference and personal satisfaction for a better quality of their work. All this does not care the reference to the remuneration lever which in itself has a relatively relative impact on the entire process. Finally, it should not be forgotten that staff evaluation must be seen above all as an incentive for improvement that can only be truly implemented through participation and sharing.

References

1. “T.S.R.M. Evaluation of staff, actors and registers” by Ornella Bertoni.
2. Guidelines on the evaluation of personnel in healthcare companies in the Basilicata Region.
3. www.riformabrunetta.it
4. Felice Marra, The coordination functions of the health professions, Franco Angeli.
5. www.normativa.it
6. Management in Healthcare – The governance of complex healthcare systems, Maria Triassi.
7. www. A.O.U. “S. Giovanni di Dio and Ruggi d’Aragona “of Salerno.
8. Lombardy Region – The evaluation system.
9. “Evaluation of management in the national health service” (operational tools); Published in 2007, written by Ivana Pelliccioli (preface by Mara Bergamaschi), published by Franco Angeli s.r.l. Milan.
10. CCNL 2010.
11. Aversa, mentality and organizational development in public administration.
12. Formez n ° 54 Department of civil service – Public Administration – By Maria Rosa Casuale; Contributions by Germana Pitrola – Editorial organization: Roberta Crudele, Vincenza D’Elia, Paola Pezzuto.