self evaluation,peer evaluation,patient satisfaction and utilization review

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SELF EVALUATIONPEER EVALUATION

PATIENT SATISFACTIONUTILIZATION REVIEW

Submitted by,Teena Jose

II M.Sc nursing Holy Cross College of Nursing,Kottiyam,

Kollam

SELF EVALUATION, PEER EVALUATION,

PATIENT SATISFACTION, UTILISATION REVIEW

Objectives….

DEFINITION

Self evaluation is defined as judging the quality of one’s work, based on evidence and explicit criteria, for the purpose of doing better work in the future.

PURPOSES• To encourage

continuing self-evaluation and reflection and to promote an ongoing, innovative approach.

• To encourage individual professional growth in areas of interest to the employee

• To improve morale and motivation by treating the employee as a professional in charge of his or her own professional growth.

• To encourage collegiality and discussion about practices among peers in an organization

• To support employees as they experiment with approaches that will move them to higher levels of performance

BENEFITS OF SELF EVALUATION

• Increased confidence • Enthusiasm • Improved team-work and

greater flexibility • awareness of new

techniques • Enhanced planning skills

TOOLS FOR SELF EVALUATION

• Staff annual professional review procedures

• Peer support

• Coaching• Joint preparation

of materials• Planning• Team building• Observation• Audit checklist

Staff annual professional review

Coaching

DEMERITS• Reluctant to fill the

self appraisal forms• The self

assessments are not always accurate.

• Conflict between the employees’ ratings and their supervisors’ rating.

PEER EVALUATION

DEFINITION• “Peer review is a process by which

employees of the same rank, profession, and setting evaluate one another’s job performance against accepted standards.”

- O’ Loughlin and Kaulbach

SUCCESS OF PEER EVALUATION DEPENDS ON• Short but objective

method • Trained observers • Constructive

feedback for faulty development

• Open communication and trust

METHODS OF PEER EVALUATION

• Direct observation• Videotaping • Evaluation of

course materials• Analysis of

portfolios

PROCESS OF PEER REVIEW

• Establish a policy requiring peer reviews

• Establish criteria for peer evaluations

• Procedure for conducting peer evaluations

Faculty chosen to conduct peer evaluations shall be tenured and hold on academic rank higher than that of the faculty member being evaluated

A written report, addressing the criteria, shall be prepared and signed by the evaluator

The department shall archive the written evaluations for use in future evaluations

• One copy of the peer evaluation shall be placed in the permanent personnel file of the person being evaluated

• All reports of peer evaluations shall be included in the tenure file, and are to be carefully reviewed at the department

ADVANTAGES:• Improves team work • Encourage group

members involvement and responsibilities

• Encourage peers to reflects on their role and contribution to the process of group work.

• Focuses on the development of judgement skills

• Provides more relevant feed back to the students as it is generated by their peers.

• Give opportunities for the hidden leaders to be selected

DISADVANTAGES• Threats to

friendship bias • Time consuming • Artificially inflated.

• Peers feels ill equipped to undertake the assessment.

• Reluctance to make judgment regarding their peers

PATIENT SATISFACTION

DEFINITION• “Patient

satisfaction is defined as a health care recipients reaction to salient aspects of the context, process, and result of their service experience.”

-Pascoe,1983

NEED FOR EVALUATING PATIENT SATISFACTION

• Data about patient satisfaction equips nurses with useful information about the structure, process and outcome of nursing care

• It is a requirement for therapeutic treatment and is equivalent to self therapy. Satisfied patients help themselves get healed faster because they are more willing to comply with treatment and adhere to instructions of health care providers, and thus have a shorter recovery time.

METHODS OF MONITORING PATIENT SATISFACTION

• Medical audit• Quality assurance

committee reviews• Indices of nursing

performances• Judgemental

method

COMPONENTS OF EVALUATION OF PATIENT SATISFACTION

• Evaluation of the programs and activities of various departments including outpatient care, inpatient care, overall health education activities of the hospital

• Evaluation of the various resources available in the hospital for effective health care

• Evaluation of effectiveness of hospital personnel including medical, paramedical, nursing as well as non-medical employees of the hospital.

• Services are relevant to the needs of the population it serves.

STRENGTHS / ADVANTAGES

• Cost effective.• Specific segments can

be easily targeted.• Wider sample

distribution possible.• Encourages high

response rate.• Visuals may be used.

• Little bias.• Patient/client anonymity.• Respondents given time

to complete.• Can use validated survey

instruments.• Qualitative comments

can be included.• Can be administered by

independent external agencies

WEAKNESSES/DISADVANTAGES• Difficulties associated

with procuring an accurate list of client/patient details.

• No opportunity for explanation or follow up questions.

• Potential to excludes sections of the population.

• Provides limited opportunities for large numbers of community members to participate in the process.

• Does not allow for the exchange of ideas and discussion.

• Reliability dependent on timing.

ULITILISATION REVIEW

AIMS AND OBJECTIVES• The main aim is to reduce

the health care costs• They work in liaison with

a business organisation to provide healthcare services to the organisation’s employees at discounted rates.

• Cost control to limit each patient’s diagnostic and treatment measures to the fewest, least expensive procedures that will relieve patient symptoms, costly complications, and return the patient to fullest possible function in the shortest time possible.

Who is a utilization review nurse..???

UTILISATION REVIEW NURSE

a registered nurse

work for insurance companie

s

examines patient cases

inspects claims

weighs the

patient's situation

a current nursing license,

TYPES OF UTILIZATION REVIEWS

Concurrent ReviewsRetrospective Review

ESSENTIAL FUNCTIONS OF UTILIZATION REVIEW NURSE

• Obtains and evaluates medical records for in-patient admissions to determine if required documentation is present.

• Obtains appropriate records as required and initiates Physician Advisories as necessary for unwarranted admissions.

• Conducts on-going reviews and discusses care changes with attending physicians and others.

• Formulates and documents discharge plans.

• Provides on-going consultation and coordination with multiple services within the hospital to ensure efficient use of hospital resources

• Identifies pay source problems and provides intervention for appropriate referrals

• Coordinates with admitting office to avoid inappropriate admissions.

• Coordinates with clinic areas in scheduling specialized tests with other health care providers, assessing pay source and authorizing payment under Medically Indigent Adult program as necessary.

• Reviews and approves surgery schedule to ensure elective procedures are authorized.

• Coordinates with correctional facilities to determine appropriate use of elective procedures, durable medical goods and other services.

RESEARCH STUDY• A study was conducted on ‘Impact of Regular

Nursing Rounds on Patient Satisfaction with Nursing Care’ by Reza Negarandeh et al on July 2014. The purpose of the study was to determine the impact of regular nursing rounds on patient satisfaction with nursing care.

• This was a controlled clinical trial in which 100 hospitalized patients in a medical surgical ward were allocated to control and experimental groups through convenience sampling. The experimental group received regular nursing rounds every 1–2 hours

• Routine care was performed for the control group. Patient satisfaction with the quality of nursing care was assessed on the second and fifth days of hospitalization in both groups using Patient Satisfaction with Nursing Care Quality Questionnaire. It results On the second day, patient satisfaction scores of the two groups had no significant difference (p = .499).

• However, the intervention was associated with statistically significant increased patient satisfaction in the experimental group compared to the control group (p < .001). It concludes Implementing regular nursing rounds had a positive impact on patient satisfaction. This method may hence improve patient-nurse interactions and promote the quality of nursing care and patient satisfaction.

REFERENCES• BOOKS• Deepak. K. A comprehensive text book on

nursing management. I edition. Emmess publication: 2013.

• Basavanthappa BT. Nursing administration. Jaypee brothers; New Delhi: 2000

• Neelam kumari. Management of nursing services andeducation. III edition. Pee Vee publication: 2011.

• B.M. Sakharkar. Principles of hospital administration and planning. III edition. Jaypee publication:2006.

• JOURNALS• Asian Nursing Research, December 2014

Volume 8, Issue 4, Pages 282–285 –URL:http://www.asian-nursingresearch.com/article/S1976-1317(14)00069-3/abstract

• NET• http://www.google.selfevaluation.com.• http://www.google.pubmed.com