Running head: PERFORMANCE ANALYSIS 1

EDID 6502 Assignment 1

Performance Analysis for Novice Nurses Entering Practice on Anguilla

Jiva Niles

320037892

University of the West Indies- Open Campus Anguilla

Dr. L. Hill
PERFORMANCE ANALYSIS 2

Table of Contents
Abstract......................................................................................................................................3
Project Development..................................................................................................................4
Background of Organization...................................................................................................4
Context................................................................................................................................4
Human Performance...........................................................................................................4
Global Issue/Problem..........................................................................................................5
Statement of Purpose..............................................................................................................5
Purpose................................................................................................................................5
Researcher’s Motives..........................................................................................................5
Gaps Identification..................................................................................................................6
Human Performance/Training Gaps...................................................................................6
Project Implementation: Analysis and Intervention...................................................................8
Performance Analysis Report.................................................................................................8
Cause Analysis......................................................................................................................13
Intervention Selection...........................................................................................................14
Reflection.................................................................................................................................15
References................................................................................................................................16
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Abstract

Time management is deemed essential in nursing practice as nurses strive to meet

multiple patient needs. A British West Indian institution, dubbed Pinnacle Health Group is

faced with issues such as late administration of pain medications, increased patient

complaints stemming from the same, and the like, as novice nurses fail to manage time

efficiently in the clinical setting. This project taken on by a consulting agency seeks to

analyse gaps in performance, pinpoint causes and devise solutions for mitigating the problem

at Pinnacle Health Group. This is done through using Human Performance Technology

Performance Analysis, Cause Analysis and Intervention Selection approaches.

Project Development

Background of Organization
Context.
The Pinnacle Health Group is a body that governs public healthcare services in a

British West Indian territory. The organization aims to provide the best quality care to all

patients served. Nurses in the acute setting serve nine patient populations, across four units, at

the general hospital. Of note, the acute setting presents factors that may or may not be

controlled by clinicians. Said factors may include environmental disturbances from

colleagues, patients and families, changes in patient status, inter alia. These factors place

strain on the time available to execute core functions. Nevertheless, time management is

integral in this general hospital setting as clinicians juggle many duties for promoting states

of patient remission. Even too, timely interventions can sometime promote prolonged patient

life. Novice nurses, nurses with < 2 years clinical experience, are often placed to work at the

general hospital as the acute setting presents greater opportunities for novices to develop their

skillset. However, there have been numerous complaints about novices not being able to

manage time effectively when placed on medical-surgical and emergent care units.

Human Performance.
Novices’ poor management of time in the clinical setting directly affects efficiency in

execution of patient care duties. Time sensitive interventions like the administration of as

needed pain medications or documenting patient care is sometimes delayed. The former

affects patient comfort and satisfaction while the latter impacts effective communication with

other care providers, thus leaving gaps in the system of care delivery. Subsequently, other

means of communication have to be explored. Additionally, oncoming shift and unit staff are

sometimes disgruntled as they sometimes have to perform tasks not completed by novices.
PERFORMANCE ANALYSIS 5

Global Issue/Problem.
Nyak (2018) reports that time management in nursing refers to how one manages self

and not time (1998). Historically, novices have had a difficult time managing time upon entry

into practice. Gossiping, answering phones, inability to prioritize tasks were a few

contributors to the problem in one hospital (Afzal, Amir-Gilani, Habib, Habib & Naseer,

2018). In the British West Indian hospital of scrutiny, similar factors come into play, but do

not entirely reflect the local context.

Statement of Purpose

Purpose.
As highlighted above, time management skills of novices can impact the efficiency of

care delivery. Furthermore, as implementing interventions in a timely fashion can affect

patient well-being, patient satisfaction, collegial relationships and organization revenue, it is

imperative that measures be put in place to improve novices’ time management problem.

Accordingly, this project is aimed at exploring root causes of novices’ time management

problem for the determination and selection of training and/or non-training interventions.

Researcher’s Motives.
This research project is not driven by financial gain. Alternatively, this project is

being pursued in order to fulfil requirements of an academic programme. The researcher is

also driven by an innate desire to attain quality standards in an environment that serves the

general population.
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Gaps Identification

Human Performance/Training Gaps.

Convenience sampling method was used to collect information. This method was

selected as the population of nurses at Pinnacle Health Group is small. To select a sample of

novices from this already small population may have reaped misleading data, or even

comprised the researcher’s ability to effectively propose solutions for addressing the problem.

Therefore, nurses who were willing to participate in data collection processes were involved

in the data collection phase. These nurses were contacted first via word-of-mouth as a means

to create interest in the problem. Subsequently, formal letters were written to solicit

participation in the research process.

Of particular interest, five novice nurses who are perceived experts at conceptualizing

the source of their own problems experienced were asked to participate in an interview. This

is so as they have first-hand experience about the issues they face in this new environment.

After summarizing their views, novices, advanced beginners, competent and expert

categories of nurses were included in a questionnaire process. Said questionnaires were

tailored based on literature findings about the phenomenon and feedback received from

novices in the preliminary interview process. Here, all participating nurses were presented

with fifteen questions aimed at determining perceptions about factors influencing how

novices spend their time carrying out various functions in the clinical setting.

For an objective, outsider’s view, two charge nurses were contacted as they regularly

observe and interact with novices. These nurses were asked to participate in an interview. The

interview schedule explored the past experiences of these individuals as novices, factors

impacting their development as nurses, their perceptions about the time management skills of

novices as well as their perceptions about environmental and organizational factors

potentially attributing to the phenomenon. Of note, the latter was perceived to be important as

environmental conditions, resources, policies and procedures may impact the way nurses plan

care and spend their time executing the same in the clinical setting.

Upon receiving feedback from novices and other experienced nurses, information

received was compared to the organization’s mission, policies and standards of performance.

Feedback received is presented in the analysis summary worksheet (See Table 1). This sheet

would be used to capture needs in relation to novices’ time management problem, deviations

in performance from desired standards, possible interventions and a summary of the situation.

However, to suit the needs of Pinnacle Health Group, and to promote a more focused analysis

of the problem, modifications to the sheet included separation of the cause gaps into

individual and environmental causes and the inclusion of a rationale section (See Table 2).

Table 1

Case Analysis Summary Worksheet

Business Need Describe the business need here.    

1.0 

Performance Clearly state the results of your gap analysis.  

gap 1.0 

Cause(s) of Describe the cause explanations associated with Gap 1.0.  Remember to

gap 1.0  consider the drivers/barriers associated with the job tasks.  

Intervention Describe the interventions you are recommending.   

1.0 

Summary
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Table 2
Pinnacle Health Group Analysis Summary Sheet
Business Need Describe the business need here.    

1.0 

Performance Clearly state the results of your gap analysis.  

gap 1.0 

Cause(s) of Describe the cause explanations associated with Gap 1.0.  Remember to

gap 1.0  consider the drivers/barriers associated with the job tasks.  

Individual:

Environmental:

Intervention Describe the interventions you are recommending.   

1.0 

Rationale(s)

Summary

Project Implementation: Analysis and Intervention

Performance Analysis Report

determine disparities between actual performance of novices and set organizational standards

of performance. Here, the named stakeholders would be approached (See Table 3). Data sets

for consideration and collection are shown below.

Extant Data. Documents would be reviewed to determine the overall performance. For

example, Electronic Medical Record Analytics reports would be generated to review data on

timing of pain medication administration.

Needs Analysis. Novice nurses, other staff nurse, charge nurses, nursing supervisors and

patients would be approached to determine perceptions on novices’ timeliness in executing

interventions

Procedural Task Analysis. Teach novices steps for developing a time management plan

Knowledge Task Analysis. Literature would be explored to determine key information and

skills novices needed to possess to in order to manage time effectively in the clinical setting.

Systems Task Analysis. Individual, organizational and environmental factors that impact

effective time management would be analysed. Subsequently, means for tackling these

unusual conditions would be considered.

Performance Analysis Plan

Information Resource Who? Where? Method? When?

Direction Mission and Vision Nursing Director Pinnacle Health Group Interview TBD

Statements
Document Review

Organizational View Strategic Plan Nurse Manager Pinnacle Health Group Document Review TBD

Work environment, Policies Nurse Manager Pinnacle Health Group Interview TBD

work, worker
Procedures Staff Nurse Document Review

Employee Manual Charge Nurse

Novice

Current Performance Interviews Nurse Manager Pinnacle Health Group Observation TBD

Level
Appraisals Staff Nurse Interviews
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Electronic Medical Record Charge Nurse Questionnaires

Analytics
Novice

Desired Performance Accreditation Guidelines Accreditation Body Pinnacle Health Group Interview TBD

Level
Standards of Performance Director of Nursing Document Review

Services

Nurse Manager

Duties and Functions of Nurse Practice Acts HR Department Pinnacle Health Group Document Review TBD

Nurses
Employee Role Description Nurse Manager

Document

Critical Issues Accreditation Evaluation Accreditation Body Pinnacle Health Group Document Review TBD

Gap Identification Electronic Medical Record Nurse Manager Pinnacle Health Group Interviews TBD

Analytics Nursing Staff

Patients
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Document Review

Prioritization of Gaps Pinnacle Health Group Interviews TBD

Questionnaires

What worker needs to Review of Databases Nursing Specialists Pinnacle Health Group Journals Reviews TBD

know
Books Management Expert Document Review
Cause Analysis

Van-Tiem, Moseley and Dessinger (2012) notes that Cause Analyses help to bridge

the gap between desired performance and substandard performance (p. 163). It is

fundamental to avoid selection of interventions for phenomena that may be solely symptoms

as opposed to causes (Van-Tiem, Moseley & Dessinger, 2012, p. 165). The table below is a

representation of causes determined using Gilbert’s Behavioural Engineering Model (See

Table 4).

Table 4

Pinnacle Health Group Cause Analysis

Information Instrumentation Motivation

Environment Charge Nurse’s or Equipment, medical Salaries

Nurse Manager’s supplies and Employee benefits

feedback about medications Non-monetary

individual available to carryout rewards

performance job functions

Behaviour Knowledge and skill Overall knowledge Various individual

deficits may exist in satisfies overall motives to work

specific areas boards of nursing

requirements
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Intervention Selection

Van-Tiem, Moseley and Dessinger (2012) advises that the best intervention selection

approach involves doing the same using a team (p. 198). Therefore, using a team approach to

share ideas about intervention options may lead to the selection of a sound intervention.

Moreover, interventions selected should be feasible, sustainable and have stakeholder support

(Van-Tiem, Moseley & Dessinger, 2012, p. 198). This suggests that interventions should

consume as few inputs as possible as well as cost-efficient. Actions to be adapted from (Van-

Tiem, Moseley and Dessinger (2012) intervention selection procedure include:

 Conducting a performance analysis and validating the performance gap

 Conducting a cause analysis and validating the cause gap

 Exploring intervention options

 Selecting an intervention collectively

 Selecting an intervention individually

 Discussing and prioritizing interventions

 Voting on interventions (Van-Tiem, Moseley & Dessinger, 2012, p. 209).

In the case of Pinnacle Health Group, time management problems seem to be related

to the environment, organization and the individual. Individual factors may be related to

novice’s poor clinical leadership skills that warrant actions like delegation and priority

setting. Nevertheless, as the writer perceives that changes in the environment can facilitate

greater efficiency for novices and other nursing staff, the writer would recommend a Work

Design intervention as the highest priority intervention for implementation. Here, the re-

assignment of rooms and the relocation of equipment and supplies may influence better time

management. Performance Support interventions like having bedside computers for

documenting care may also promote real-time documentation of care and costs associated
PERFORMANCE ANALYSIS 15

with novices having to stay overtime to ensure that events of the clinical day are documented.

Last, and of lowest priority, the writer would recommend that novices receive training aimed

at developing time management skills.

Reflection

Results-oriented, interconnected systems, values and partnerships are among

standards that govern Human Performance Technology (Van-Tiem, Moseley & Dessinger,

2012, p. 42). Accordingly, I enjoyed carrying out this project as quality improvement is one

of the areas that I am most interested in as a Registered Nurse. Reviewing steps for

conducting a Performance Analysis and Cause Analysis has helped me to view problems

using a magnifying lens as opposed to vacuum that I applied formerly. Here, I abandoned my

innate tendency to arrive at speedy conclusions about the matter. Failure to examine

components of problems can lead to rectifying conditions that are not true causes of the

problem. For instance, I originally felt that training may have been the best choice as it would

teach or remind novices about time management strategies. It is through looking at

components of Gilbert’s Behaviour Engineering Model that I realized that changes to the

environment could improve efficiency of care interventions for all healthcare staff.
PERFORMANCE ANALYSIS 16

References

Afzal, A., Amir-Gilani, S., Habib, A., Habib, T., Hussain, M. & Naseer, A. (2018). Factors

affecting professional nurses at public hospital, Lahore. International Journal of

Social Sciences and Management, 5(3), 231-235. doi:10.3126/ijssm.v5i3.20606

Nyak, S. (2018). Time management in nursing: hour of need. International Journal of Caring

Sciences, 3(11), 1997-2000. Retrieved from https://www.internationaljournalofcaring

sciences.org/docs/72_nayak_special_11_3_2.pdf

Van-Tiem, D., Moseley, J. L., & Dessinger, J. C. (2012). Fundamentals of performance

improvement (3 Ed.). San Francisco, CA: Pfeiffer.