360 Degree Feedback for Doctors

360 degree Feedback for Doctors

Aim
• Design of a 360 degree PE for doctors in KMC

Objectives
• To map current performance evaluation system for doctors
• To analyze and figure out areas of improvement
• To design 360 degree feedback system

Scope
• The project is done for academic purpose, it needs deep
study to implement in the hospital
Literature review
• 360-degree feedback can be a positive force for practice improvement provided skilled
facilitators are available
• to encourage reflection, concrete goals are set and follow-up interviews are
carried out
• Hospitals 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 improvement
Inclusion and exclusion criteria


 The instruments needed to fulfil the following criteria:
 Template prepared by consultants from different specialities
 Assess practising doctors
 Have 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 and
 They had not been used for individual feedback



INTERACTIONS POINTS
• Nurse
• Pharmacy
• Lab technicians
• Radiologist
• Patients
• Patient party
• Junior doctors
• Senior doctors
• Interns
• Post graduates
• Hospital Administrator







Methodology
• Personnel interviews
 Nurses (2)
 Doctors (2)
 Pharmacist (1)
 Lab technician (1)
 Radiology lab technician (1)

o To understand
Current performance evaluation system
Where they can provide their inputs to evaluate doctors
How 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 diagnosis
Dean/MS
Senior doctors
(HOD)
Junior doctors
(Prof. or
assistant prof.)

• Parameters for evaluation in KMC
 Active interest
 Initiatives taken
 Communication
 Leaves taken
 Health of doctor
Diagnostic 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 exists
• Existing system is highly hierarchical
• Interactions high only with nurses & PG’s/Intern’s
• But nurses, staff or PG’s/Interns do not evaluate doctors
• Evaluation system is Top to bottom

 Areas for development:
• Involvement of other coworkers who also have a stake in
patient’s safety and prevention of errors
• Performance reviews at regular intervals
 Performance & Development planning:
• Performance results – What
Performance outcomes or standards – from job description
Performance objectives for the next time period
• Performance behavior – How
Competencies, performance factors, or behavior
expectations
• Development objectives: Patient centric



Design


Existing parameters


New parameters
•Active interest
•Initiatives taken
•Communication
•Leaves taken
•Health of doctor

•Communicating disease and
intervention
•Listen to patient and taking history
•Taking specific measure for patient
safety
•Knowledge
•Team work
•Diagnostic and treatment skills
•Assisting junior doctors
•Diagnostic skills
•Taking advice when appropriate
•Daily rounds
•Cross Consultation
•Number of tests written

 Goal setting:
• Organizational goal: clinical excellence, Patient centricity & ethical practices
 Feedback can be given by the co-workers, Patients as well as the Peers
 Assessment: By the facilitators
 The 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 OUTCOME
Doctors
Co-workers
patient
Peers
Nurse
Radiologist
Lab Technician
Pharmacist
Pg/Interns
Self
evaluation
Parameters for Assessment
Nurses
• Communication
• Daily rounds
• Prognosis
• Cross Consulting
• Other Soft skills
PG/Interns
• Number of medication
• Number of tests written
• Assisting junior doctors
• Diagnostic skills
• Taking advice when
appropriate
Co-workers
Parameters for Assessment
• Time Spend with patient
• Communicating disease and intervention
• Listen to patient and taking history
• Daily rounds
• Soft skills
• Satisfied with tests and medication given
• Taking specific measure for patient safety
Patients
• Knowledge
• Skills
• Communication
• Team work
• Handling patients
• Diagnostic and treatment skills
Peers
/
Seniors
• All the employee’s 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 period
• The employees & mangers undergo a pilot test to avoid any kind of confusion



Implementation
• Evaluate performance results and behaviors
• Conducted 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 done
• Reflections helped the consultants to see that improvements were needed
• Examining their strengths and weaknesses in a portfolio would give them insight into
the quality of their performance
• Facilitators: would gauge the accuracy of their reflections
• Annual assessments (follow-up) would stimulate them to take action
• Repeated exposure to improvement goals and would enhance the likelihood
of performance improvement
Operations
Contextual factors that affect
development of PM
• Factors related to hospital and consultant group:
• Work Load
• Cultural Aspects
• Lack of openness among the people
• Lack of social support
• Lack of management commitment: All goals should not be laid on the doctor’s
door
• Factors related to society
• Public Distrust



Thank You