Staff Performance Competency
Please assess Strong Commitment Competence against the performance factors as follows:
Exceeds (E) - consistently performs in an exceptional manner that far exceeds performance standards.
Meets (M) - consistently performs in a manner that fully meets expected performance standards.
Needs Improvement (NI) - performs in a manner that needs improvement—identified area of growth.
Integrity – I will conduct myself in a fair and trustworthy manner.
Self
Evaluator
(Type E, M or NI)
Demonstrates meeting customer needs by providing the highest quality service with utmost care
and courtesy; recognizes his/her work as a reflection of him/herself.
Ensures patients' right to privacy by creating a secure and trusting environment. Treats all patient
information confidentially.
Uses good judgment in all situations, ensuring ethical standards are met.
Comments:
Compassion - I will act with empathy and understanding toward others.
Commits to understanding patient and family members' unique, individual needs.
Uses good judgment in all situations, ensuring ethical standards are met.
Responds to patients in a timely manner by giving status reports; uses care and courtesy when
responding.
Comments:
Accountability - I have an obligation to take responsibility for my actions and to join with my colleagues in
realizing the hospital's vision.
Follows through on all assigned duties/responsibilities to ensure they are completed correctly and
in a timely manner.
Solves problems rather than blaming others or offering excuses.
Values and supports co-workers and actively participates in team's success.
Comments:
Respect - I will treat patients, families and colleagues with dignity and sensitivity, valuing their differences.
Introduces self, greeting others warmly, offering assistance.
Strives to better understand the diverse cultures and customs of patients and their families.
Uses words and tones appropriate to a health care setting.
Comments:
Excellence - I will rise above the ordinary through my personal efforts and those of my team.
Treats co-workers with courtesy, consideration, respect and trust. Recognizes that he/she is part
of a team.
Engages in continuous learning to promote personal and professional growth.
Works to create team success as well as individual success.
Helps to maintain our facility by keeping it clean and uncluttered.
Comments:
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Employee Signature
Evaluator Signature
__________________________________________
_____________________________________
Employee ID #
Date
In keeping with the Mission, Vision, and Values of Strong Memorial Hospital, all employees
are responsible for the delivery of care and services that reflect the Strong Commitment and
are consistent with the following values and expected behaviors.
A PERSONAL COMMITMENT TO OUR VALUES
Integrity -
I will conduct myself in a fair, responsible and trustworthy
manner.
Compassion - I will act with empathy and understanding towards others.
Accountability Respect Excellence -
I have an obligation to take responsibility for my actions
and to join with my colleagues in reaching the hospital’s vision.
I will treat patients, families and colleagues with dignity and
sensitivity, valuing their differences.
I will rise above the ordinary through my personal efforts and
those of my team.
BEHAVIORS THAT SUPPORT OUR COMMITMENT
1. Wear neat, proper dress, including a visible ID badge.
2. Greet others warmly, offer assistance and escort them to their destination if
needed.
3. Introduce yourself and explain your role.
4. Use words and tones appropriate to the healthcare setting.
5. Respect every person’s privacy (knock before entering a room, pull privacy
curtains where possible).
6. Always give patients and families priority (in elevators, lines, parking lots).
7. Solve problems rather than blame others or offer excuses. Apologize for any
inconveniences.
8. Be flexible and willing to listen to ideas that are different from your own.
9. Value and support your co-workers and actively participate in team success.
10. Keep our hospital clean (report spills, pick up trash and reduce clutter).
I have read and understand that I am responsible to adhere to the above Strong Commitment
Standards and Strong Commitment Performance Behaviors. I acknowledge that my failure to do so
will result in disciplinary action up to and including termination.
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Signature
Date
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Print Name
Employee ID #