Knowledge: Barrier to the Effective Implementation of the - - PowerPoint PPT Presentation

University of Pretoria Moselene AR du-Plessis

Knowledge: Barrier to the Effective Implementation of the Performance Management and Development System (PMDS) in Selected Primary Health Care Clinics in Gauteng.

Introduction and Background

• Methodology used to manage human performance in the public service did not

drive human performance, nor did it improve the quality of service public citizens is entitled to.

• Prior to 1994 the SA health system was built on an apartheid ideology,

characterised by racial and geographic disparities.

• 14 Departments of Health, each with its own objectives, and no deliberate focus
• n providing quality health care to all South Africans (Tshabalala-Msimang

2004:1).

• Automatic rank promotion and increment, memory and incident.
• .

Background

• A policy vacuum existed between 1994 and 2003;
• The old policy of automatic notch increment was phased out by the new
• administration. No policy was, however, introduced to replace the old policy

directive(Paile 2012:3) .

• Service delivery imperatives and the quest for improved performance has led to

policy formulation of a new unified PMDSin the national and provincial spheres

• f government by April 2001 (Mogaladi 2003:81).
• DPSA developed broad guidelines and statutory framework that served as a

national guide to provincial departments in developing and ultimately implementing their own PMDS (du Toit et al. 2002:194).

Background

• The incentive policy framework was adopted in 2003 followed by the PMDS. The Public

Service Regulations, 2001 state that employees who perform at satisfactory levels should be rewarded.

• The reward should be in the form of pay progression, which is equal to a 1% notch

increment. The aim and objectives of these policies was ensuring that pay progression /notch increment, was directly linked to employee job performance in compliance with the Public Service Regulations, 2001.

• Those who perform more than satisfactory should be rewarded with incentives such as cash

bonuses to the maximum of 18% of their annual notch, plus pay progression (Department of Public Service and Administration 2003:6).

• The PMDS has emerged as a key fundamental and comprehensive tool for developing and

managing employees in the public health sector. (Sangweni 2003:20).

Background

• PMDS: Is an authoritative framework for managing employee performance, which includes

the policy framework as well as the framework relating to all elements in the performance cycle, including performance planning and agreement; performance monitoring, review, feedback and assessment (Bacal 1999:3).

• Seeks to transform the public service from bureaucracy to a result-driven organisation,

delivering on the South African government's social contract with the people.

• The overall purpose of the PMDS is therefore to collect accurate data and provide

information on how well employees have performed during the 12-month period of the PMDS cycle.

• Solomon (2003:36) suggests that, to get successful results from the PMDS, there must be

sound strategies in place that drive the individual work performance of personnel in an

• rganisation.

Background

• The starting point in a PMDS is a clear definition of the org

mission, aims and values, which gives the PMDS a strong strategic focus.

• The PMDS has a vital role to play in ensuring that human

resource strategies support the directions of the institution, by providing a basis for assessing and improving individual and institutional performance against predefined strategies and

• bjectives.

Background

• Getting

successful results from the PMDS necessitates the person responsible for the implementation, to obtain accurate information.

• If this does not happen, planning and future

performance will be compromised, with a direct influence on the quality of care.

Research problem (What is the gap)

• Despite having – for more than a decade an

established system, professional nurses still experience the PMDS as non-beneficial, confusing and not driving performance.

Research objectives

• To

explore and describe the knowledge

• f

professional nurses have about the PMDS.

• To explore and describe current practices of

professional nurses concerning the PMDS process to follow during the 12 month cycle .

Research method

• Quantitative, non-experimental and descriptive survey by means of a questionnaire was used to

gather data. Population and sampling

• Professional nurses(n=60) working at the two selected PHC clinics within the Tshwane

district.

• A criterion based sampling method was used to select participants.
• focused on individuals who were using the PMDS, professional nurses who were directly

involved in the managing of the performance of employees at the selected clinics.

Pilot study

• Three (3) professional nurses from each clinic, a total of six (6).
• The results of the pilot study were not included in the final study.

Data collection

• Self administered questionnaire
• The closed-ended questions allowed the participants to choose

the relevant answer.

• The open-ended questions were not based on predetermined

answers, therefore it was required from all participants to complete a sentence where warranted.

• 56 questionnaire distributed, 37 returned = 72% response rate.

Data analysis

• The data was quantitatively analysed with the

Statistical Analysis System (SAS) version 8.2 software program.

• Tables and graphs were used to explain the

distribution, variety and trends in response to the sample as a whole.

Ethical considerations

• Written consent from participants.
• Permission to conduct the research relevant

authorities.

• No identifying personal information was used in any

part of the research.

• Participants in the study remained anonymous.
• The anonymity of the PHC clinics was protected, as

the same sealed box was used to collect all the completed questionnaires from both clinics.

Discussion of results:Section A: Demographic

profile of participants

As nursing is a female dominated profession, the findings confirmed this as 37 (95%) were female participants, 2 (5%) were males. Ages of participants.

Participants years of experience

69% 21% 10% 0% 10% 20% 30% 40% 50% 60% 70% 80% 1–9 years 10–19 years 20+ years

• (69%) participants have been working in PHC for less

than ten years.

• The length of time participants had spent in this type
• f service, could have contributed to aligning all efforts

towards achieving goals.

• It is the extent to which the PHC goals are achieved

that is determined by the PMDS.

Professional qualifications

• Nearly half followed the general nurse route, followed by

additional courses.

• It is unusual to find an intensive care trained nurse in a primary

health care facility, especially with the occupational skills dispensation (OSD).

• It is, however, possible that this person was one of the older

participants who did not want to work in such a stressful area.

• The number of participants with post-basic qualifications was

limited, so it could be that their broader exposure to developmental opportunities was limited.

:

Workshop attendance

Workshop attendance

• The participants were also requested to indicate whether they

had ever, at any time previously, attended a workshop on the PMDS in their particular clinic.

• The low PMDS workshop attendance rate (45%) could have

contributed to the original problem, namely that the professional nurses felt that the PMDS was confusing and non-beneficial and that it did not drive performance.

Section B: Knowledge of the participants regarding the PMDS

• Knowledge can be differentiated from information or data.

Information and data explain what happened and what exists whereas knowledge enlightens one as to what works, what matters, what we should trust, where things went wrong and how one can fix them.

• Tools of information technology provide us with the data,

knowledge is needed to understand and apply those basic facts to changing situations.

• Only knowledge can bring data and information to the next level

by showing one how to take what has been learnt, and put it to use.

Performance planning and agreement

• Performance planning and agreement comprise the basis of

performance management at individual level.

• Before the employees sign a performance agreement (PA), they

should have clarity about what should happen when.

• The majority of participants (62%) lacked knowledge pertaining

to the date for signing a PA.

• With regard to identifying the most important aspect of the

PMDS process, participants (67%) lacked knowledge thereof.

• Participants (72%) had no idea about the first step in the

performance cycle.

• This lack of knowledge could result in employees not having

clarity about which goals they are expected to achieve.

Performance work plan

• If an employee signs a PA without having a work plan, it will be

impossible to manage and develop the employee during the performance cycle.

• The KPAs and the GAFs are contained within each employee’s

work plan, and are used as criteria for measuring his or her work performance in terms of output and observable behavioural change.

• (77%) of the participants had adequate knowledge of what the

KPAs indicated to the employee, The positive results item creates the impression that the participants were knowledgeable about the role of the KPAs.

Performance monitoring

• In nursing, the concept of monitoring is a function well

understood.

• This lack of knowledge could give rise to poor or no performance

monitoring of personnel as well as invalid and unreliable results.

• This could also result in the failure to uncover the root causes and
• bstacles in the way of optimal performance, and a lack of

constructive ideas for improvement.

• Improved service delivery can only be achieved if the individual

employees participate actively in discussions and decision- making pertaining to their job performance, with their managers.

Performance review

Correct Incorrect n Purpose of the review 31% 69% 39 What review forms part of 56% 44% 39

31% 56% 69% 44% 0% 20% 40% 60% 80% 100% Purpose of the review What review forms part of Correct Incorrect

• It is not clear why the participants, though not knowledgeable

about the purpose and frequency of monitoring, knew that the performance review was part of the monitoring process.

• The performance review and feedback sessions ensure that the

employee has no doubt as to which outputs have been achieved.

• Improved service delivery can only come to pass if the individual

employees participate actively in discussions and decision- making pertaining to their job performance, with their managers. Thus, it is important for professional nurses to know what performance review and feedback entails.

Performance assessment

• participants (95%) had limited knowledge regarding the criteria

against which the performance of the employee should be assessed.

• participants (67%) did not know how to prepare for the final

performance assessment of subordinates

• The reason for this lack of knowledge considering the final

performance could most likely be that, because there is such an

• verall lack of knowledge regarding the PMDS, the participants

are unable to recognise the bigger picture. This would also then be the reason why the participants described the PMDS as confusing, non-beneficial and not driving performance.

Limitations

• The author recognises certain limitations to this research study.
• This study was the first of its kind to be conducted within the

nursing health care profession since the implementation of the PMDS in 2003. Consequently, the researcher experienced difficulty in finding any similar studies.

• The study was limited to only two PHC clinics in the Tshwane

district, resulting in generalisations and applications not being possible.

• A larger sample population, representing all registered nurses of

the Tshwane district health care clinics, would have been more significant.

Recommendations

• The following recommendations are made with regard to the

study:

• It is highly recommended that in-service training courses be
• introduced. These courses should be part of a capacity-building

programme which should involve demonstrators and preceptors.

• A pilot study can be done using the 360º evaluation method to

determine whether it would be beneficial to improve the knowledge of personnel responsible for implementation of the

• PMDS. This could help to identify the level of acceptability of the

PMDS by employees, as it directly influences the decisions of management regarding their future.

Conclusion

• The PMDS remains a controversial topic in public health care
• settings. The research findings showed that participants had poor

knowledge about performance agreement, planning, monitoring ,review and assessment of the PMDS.

• The fact that this lack of knowledge has a negative influence on

staff commitment, the quality of patient care and nursing service in general, calls for remedial action to improve the current

• situation. It is thus important that those involved in the utilisation
• f the PMDS are well versed in its usage.

Conclusion

• It is recommended that top management should be more

involved throughout the PMDS process so that problem areas can be identified earlier and the necessary remedial actions

• implemented. It should not just be assumed that everyone

involved in the PMDS knows the what, why and how of the system.

• The above discussion vindicates that a platform to address the

problem needs to be established in the interest of employee.

Questions and Comments