Study on knowledge and attitudes among management and non management health staff towards existing perfomance appraisal system and, identification of implementation gaps in curative primary care institutions of Badulla health region

Abstract

To determine the knowledge and attitudes managerial and nonmanagerial staff members towards existing performance appraisal system and identification of implementation gaps, in curative primary care institutions of Badulla health region. There are 879 health workers in 49 primary curative care institutions in Badulla health region. A sample of 29 institutions was drawn out by stratified random sampling method. The number of employees included in the study was 517. Out of 517 there were 50 managerial staff members and 467 non managerial staff members. All employees were tested for some aspects of basic knowledge on the concept of performance, and the general performance appraisal system operating in the institutions, through a self administered questionnaire. The respondents were categorized into four groups according to the score of knowledge (weak 0-24, fair25-49, good 50-74, very good 75-100) Employee attitudes towards different dimensions of current performance appraisal system including possible errors of implementation were assessed through a five point Likert scale data collection form. Attitudes were scaled as Strongly agreed (+2), Agreed (+1), either agreed or disagreed (0), Disagreed (-1), Strongly disagreed (-2). Employees of one selected institution from a sample District Hospitals, were interviewed in depth, based on the results obtained by above mentioned instruments, to identify implementation gaps of the system. Two managerial and twenty one non managerial staff members were interviewed in identification of implementation gaps. Managerial staff members had a comparatively higher knowledge than non managerial category. Out of managerial category nursing officers had the best knowledge, overseers were last, and officers in charge were somewhere in between. Attitudes of both managerial and non managerial staff towards the necessity of a performance appraisal system to improve health care services, and not giving due consideration for implementation of current performance appraisal system at institutional level, were positive beyond any doubts. Generally, all the other attitudes were positive with I title negative potential on some occasions. Out of two managerial staff members interviewed in depth, only one had undergone training on performance appraisal. The officer in charge of the institution had not undergone any type of training in relation to performance appraisal. Only the trained managerial staff member knew the implementation strategies of the system and she was confident enough to implement the system. Only one non managerial staff member out of 21 seemed to be motivated through performance appraisal. Record keeping on performance appraisal was very poor and both managerial and non managerial staff members expressed ideas in favour of this gap of implementation. Short supply of forms and lack of commitment of management assistant were important implementation gaps of the system. Lack of supervision at regional or institutional level was another gap in implementation of the system, both staff categories agreed on this factor. Managerial staff members had a comparatively higher knowledge on performance appraisal. Out of managerial staff, nursing officers in charge had the best knowledge. Attitudes towards "necessity of a performance appraisal system "and "not giving due consideration for implementation" were positive beyond any doubts. Common implementation gaps were, lack of knowledge and confidence in implementation, among managerial staff and lack of supervision.