BUSI 344 Week 5 Discussion Board Forum 5 Example

Discussion Board Forum 5: Performance Management in Health Care

BUSI 344 Human Resource Management in Healthcare Administration, Discussion Board Forum 5

Thread by [Student Name]

The hospital, its appraisal process and the classmates are composites; the textbook, Scripture and the peer-reviewed articles cited are real.

At our hospital, every nurse received one performance review a year, a form with ten ratings completed by a unit manager who might supervise eighty people and rarely saw any of them at the bedside. Nurses told human resources the reviews felt unrelated to their work and that the only real outcome was a small raise. Niles (2013) explains that performance appraisal should serve two purposes: evaluation, which supports decisions about pay and promotion, and development, which helps employees improve. Our process served the first poorly and the second not at all, because a nurse cannot act on feedback that arrives months after the events it describes. It was also vulnerable to the rater errors the chapters describe, such as judging the whole year by the most recent month.

Research pointed to two changes. Wise et al. (2026) followed 521 new graduate nurses whose performance was appraised at one, three and nine months and found that average scores rose from about 74 to about 95, a 28% improvement, showing that performance changes quickly and that assessments at several points capture growth an annual review would miss. Khaleghparast et al. (2026) compared 360-degree evaluations, which drew on supervisors, coworkers, self-ratings and patient feedback, with conventional head nurse ratings for 137 cardiac nurses and found that the two methods produced different scores, especially for interpersonal skills.

Our new process has two parts. First, every nurse meets with a charge nurse or manager for a short check-in each quarter focused on one strength and one goal, with no rating attached. Second, the annual review now includes brief input from two peers chosen by the nurse and the manager together, along with the nurse's self-assessment. We will survey nurses after one year to see whether they find the process useful and track whether goals set in check-ins are met. Managers will receive brief training in giving specific feedback and in avoiding common rating errors before the first quarter begins.

Proverbs teaches that iron sharpens iron, and one person sharpens another (English Standard Version Bible, 2001/2016, Proverbs 27:17). Feedback that arrives once a year is a verdict; feedback that arrives every few months is help.

Reply to Jasmine

Jasmine, your hospital ranks nurses each year and places the lowest tenth on improvement plans. Forced ranking can feel decisive and objective to leaders, but it assumes a fixed share of poor performers on every unit and can damage teamwork. Martínez (2026) argues that peer accountability, in which colleagues hold one another to shared standards, explains much of why some teams perform well, and ranking peers against one another can undermine exactly that kind of cooperation. Lainidi et al. (2023) found that staff speak up when the culture supports it, and a system that pits nurses against each other may teach them to stay quiet. The textbook warns that appraisal standards should reflect the job and be used the same way for everyone (Niles, 2013), a principle forced quotas can break. Paul asked the Thessalonians to strengthen and encourage each other, as they were already doing (English Standard Version Bible, 2001/2016, 1 Thessalonians 5:11). Could your hospital rate nurses against clear standards rather than against each other, and keep improvement plans for those who truly fall short?

Reply to Owen

Owen, thank you for describing your clinic so clearly. You said your clinic's annual review is the only feedback medical assistants receive. That leaves most of the year without any guidance at all, and it means a problem noticed in February may not be discussed until December. Wise et al. (2026) found that new nurses' performance improved sharply over their first nine months when it was assessed at regular intervals, which suggests that more frequent check-ins capture growth and problems while there is still time to act. Evans (2025) showed that structured mentoring improved new nurses' sense of support, a benefit that regular feedback conversations can also provide for assistants. Niles (2013) describes appraisal as an ongoing process, not a single event. Hebrews encourages believers to consider how to stir one another up to love and good works (English Standard Version Bible, 2001/2016, Hebrews 10:24). Would your clinic's managers have time for a ten-minute check-in with each assistant every quarter, perhaps scheduled during a slower afternoon so it does not compete with patient care?

References

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Evans, K. (2025). Improving the perception of support through mentoring of new to practice nurses. Journal of Continuing Education in Nursing, 56(2), 45-47. https://doi.org/10.3928/00220124-20250121-02

Khaleghparast, S., Kamali, M., Chaibakhsh, S., Sari, L., Khosrobeigi Bozchaloei, F., Mazloomzadeh, S., & Karimian, S. (2026). Comparing the impact of 360-degree evaluation and conventional methods on the performance evaluation of Iranian nurses. Journal of Education and Health Promotion, 15, 257. https://doi.org/10.4103/jehp.jehp_110_25

Lainidi, O., Jendeby, M. K., Montgomery, A., Mouratidis, C., Paitaridou, K., Cook, C., Johnson, J., & Karakasidou, E. (2023). An integrative systematic review of employee silence and voice in healthcare: What are we really measuring? Frontiers in Psychiatry, 14, 1111579. https://doi.org/10.3389/fpsyt.2023.1111579

Martínez, M. (2026). Peer accountability in patient safety: An under-examined determinant of team performance. International Journal for Quality in Health Care, 38(3), mzag134. https://doi.org/10.1093/intqhc/mzag134

Niles, N. J. (2013). Basic concepts of health care human resource management. Jones & Bartlett Learning.

Wise, M. A., Takashima, M., Ossenberg, C., Ellem, P., & Henderson, A. (2026). New graduate nurses' transition to practice: A longitudinal quantitative analysis of factors that impact workplace performance. Nurse Education Today, 167, 107213. https://doi.org/10.1016/j.nedt.2026.107213