360 degree Feedback for Doctors
360 degree Feedback for Doctors AimDesign of a 360 degree PE for
doctors in KMC
ObjectivesTo map current performance evaluation system for
doctorsTo analyze and figure out areas of improvementTo design 360
degree feedback system
ScopeThe project is done for academic purpose, it needs deep
study to implement in the hospitalLiterature review360-degree
feedback can be a positive force for practice improvement provided
skilled facilitators are availableto encourage reflection, concrete
goals are set and follow-up interviews are carried outHospitals
should be aware of the existing lack of openness and absence of
constructive feedback Consultants indicated sharing personal
reflections with colleagues could improve the quality of collegial
relationships and heighten the chance of real performance
improvement.A questionnaire based process 360-degree can be an
effective means of assessing physicians & has stimulated
practice improvementInclusion and exclusion criteria
The instruments needed to fulfil the following criteria:
Template prepared by consultants from different specialities Assess
practising doctorsHave capacity to assess individual doctors for
performance feedback and Inclusion of facilitators Instruments were
excluded if any of the following were evident:They assessed medical
students, nurses or non physicians They assessed purely at an
organizational level andThey had not been used for individual
feedback
INTERACTIONS POINTSNursePharmacyLab
techniciansRadiologistPatientsPatient partyJunior doctorsSenior
doctorsInternsPost graduatesHospital Administrator
MethodologyPersonnel interviews Nurses (2) Doctors (2)
Pharmacist (1) Lab technician (1) Radiology lab technician (1)
To understandCurrent performance evaluation system Where they
can provide their inputs to evaluate doctorsHow frequently they
interact with doctors
Questions asked:Is performance evaluated?Existence of a
performance appraisal system for doctors?Number of interactions
with doctors
Existing practice:
Analysis and diagnosisParameters for evaluation in KMCActive
interestInitiatives takenCommunicationLeaves takenHealth of
doctorDiagnostic survey:Interaction with doctors, regarding
existence of a system in which the other professionals are involved
for performance appraisal
Diagnostic summary:Performance evaluation for doctors
existsExisting system is highly hierarchicalInteractions high only
with nurses & PGs/InternsBut nurses, staff or PGs/Interns do
not evaluate doctorsEvaluation system is Top to bottom
Areas for development:Involvement of other coworkers who also
have a stake in patients safety and prevention of errorsPerformance
reviews at regular intervalsPerformance & Development
planning:Performance results WhatPerformance outcomes or standards
from job descriptionPerformance objectives for the next time
periodPerformance behavior HowCompetencies, performance factors, or
behavior expectations Development objectives: Patient centric
Design Existing parameters New parametersActive
interestInitiatives takenCommunicationLeaves takenHealth of
doctor
Communicating disease and intervention Listen to patient and
taking historyTaking specific measure for patient
safetyKnowledgeTeam workDiagnostic and treatment skillsAssisting
junior doctorsDiagnostic skillsTaking advice when appropriate Daily
roundsCross ConsultationNumber of tests written
Goal setting: Organizational goal: clinical excellence, Patient
centricity & ethical practicesFeedback can be given by the
co-workers, Patients as well as the PeersAssessment: By the
facilitatorsThe rating would be done on the basis of questionnaires
with Likert scale developed by physicians from various
specialties(for patients instruments)The facilitators would
encourage reflection among the consultants ,also help in making
concrete goals Personnel development planning:Encouraged sharing
personal reflections with colleagues that could improve the quality
of collegial relationships and heighten the chance of real
performance improvement
CRITICAL INTERACTIONS TO IMPROVE PATIENT
OUTCOMEDoctorsCo-workerspatientPeersNurseRadiologistLab
TechnicianPharmacistPg/InternsSelf evaluationParameters for
AssessmentCo-workersParameters for AssessmentAll the employees are
communicated about the performance appraisal system as soon as they
join the organization.They are updated of the Appraisal system
& the process of execution.They all also informed about the
relation between the performance appraisal & the compensation
as well as the assessment periodThe employees & mangers undergo
a pilot test to avoid any kind of confusion
ImplementationEvaluate performance results and
behaviorsConducted face-to-face with a written record.While rating
and ranking pros and cons would be considered, a summary rating of
each employee would be doneReflections helped the consultants to
see that improvements were neededExamining their strengths and
weaknesses in a portfolio would give them insight into the quality
of their performanceFacilitators: would gauge the accuracy of their
reflectionsAnnual assessments (follow-up) would stimulate them to
take actionRepeated exposure to improvement goals and would enhance
the likelihood of performance improvementOperationsContextual
factors that affect development of PMFactors related to hospital
and consultant group:Work LoadCultural AspectsLack of openness
among the peopleLack of social supportLack of management
commitment: All goals should not be laid on the doctors doorFactors
related to societyPublic Distrust
Thank You
