The role of Performance appraisal system on Compassionate, Respectful, and Caring health care delivery in Northwest Ethiopia: an implementation study

Abstract

 Background: Performance appraisal (PA) is the process of deciding how employees do their jobs. This helps to identify problems and take remedy early. Moreover, performance appraisal is an essential element for health care delivery practices of health care providers, which shapes the overall health care delivery practices in Compassion, respectful and caring (CRC) manner. However, there is a lack of studies examining the role of performance appraisal system on CRC health care delivery practice. Therefore, the current study aimed to explore the role of performance appraisal system on Compassionate, Respectful, and Caring (CRC) health care delivery practice.

Methods: For this implementation study a phenomenological qualitative inquiry was used. The data was collected by using a piloted interview guide. We collected data using in-depth interviews (IDIs) and key informant interviews (KIIs) among purposively selected health work force. Thematic analysis using Open code 4.03 was performed.

Results: Based on the data driven from this study the primary focus of the study is categorized broadly into five key themes, namely: process of performance appraisal, integration of CRC element in the performance appraisal, barriers for performance appraisal, facilitators for performance appraisal and potential strategies to strengthening CRC implementation. Poor motivation of professional for evaluation, skill gap, lack of civil service guideline, and lack of supportive supervision were the potential barriers of PA on healthcare delivery. Whereas, the presence of recognition, presence of Balanced Score Card (BSC) evaluation, and gap identification and capacitate were few of the facilitators.

Conclusion: In this study, the performance appraisal is poorly coordinated in the health system. The elements of CRC were poorly integrated and less weighted in the current practice of PA system. Lack of standard measurement tool, scoring problem, and system barriers were the main challenges of performance appraisal. Therefore, a capacity building on the process of performance appraisal system and the integration of CRC elements on the appraisal should be designed to improve the CRC health care delivery practices.