Outpatient Manager Tool
Page 1 of 6
MANAGER / ASSISTANT MANAGER / CHARGE NURSE FEEDBACK TOOL: Outpatient Areas
Subject’s Name: ___________________________________ Evaluator’s Name: _________________________________
Requires Evaluation Descriptors (Quality & Effect on Team) for reference
PLANNING & MANAGING CARE
1. Practice adheres to specialty and
organizational standards.
2. Addresses pt safety needs (ex: pt
identification, medication
ordering/administration accuracy, lab
processing, troubleshoots missing
documentation/medical records, Xrays,
labs).
3. Applies age-specific/cultural
considerations to care of patient.
4. Triages patient care.
5. Identifies pt problems that need to be
referred to PCP or provider other than
this clinic.
6. Manages patient flow and identifies
problems that impede patient flow for
maximum efficiency.
7. Appropriately communicates changes in
patient condition.
8. Takes on additional clinical
responsibilities and/or assists others.
9. Organizes work and manages changes
in work demands for effective use of
time.
10. Delegates to staff appropriately, with
consideration for other team members’
workload.
11. Patients and families are satisfied with
the care this nurse has given.
Job
Description
Quality/
Expertise
Effect
on
Team
Specific /Example(s) recommended for above level
criteria; especially in support of advancement
RN 1-4
RN 1-4
RN 1-4
RN 1-4
RN 2-4
RN 2-4
RN 1-4
RN 2-4
RN 2-4
RN 2-4
RN 1-4
©Nursing Research Office – Vanderbilt Univ. Medical Center
Revised 05/2006
Outpatient Manager Tool
12. Manages complex clinical situations.
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RN 2-4
It is required to describe specific example(s) for each Key Function. Please enter specific example(s) below:
CONTINUUM OF CARE PLANNING
Discharge or transfer to the next level of care
planning.
1. Identifies pt/family needs and initiates
plan for movement to next level of care.
2. Uses internal & external referrals &
resources that support pt/families
through continuum of care.
3. Initiates change in plan for next level of
care in unexpected, changing and
complex situations.
Job
Description
Quality/
Expertise
Effect
on
Team
Specific /Example(s) recommended for above level
criteria; especially in support of advancement
RN 1-4
RN 1-4
RN 3-4
4. Acts to resolve systems breakdowns,
knowledge, behavior issues that impact
RN 3-4
continuum of care needs.
It is required to describe specific example(s) for each Key Function. Please enter specific example(s) below:
©Nursing Research Office – Vanderbilt Univ. Medical Center
Revised 05/2006
Outpatient Manager Tool
PATIENT / FAMILY EDUCATION
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Job
Description
Quality/
Expertise
Effect
on
Team
Specific /Example(s) recommended for above level
criteria; especially in support of advancement
1. Incorporates a variety of resources to
teach and support pt and family learning
RN 1-4
(Ex: EZTV, pt ed materials, web
sources, drawings, etc).
2. Individualizes patient/family education
for complex patients/families (Ex:
RN 3-4
resistant, non-compliant, significant
barriers to learning).
3. Led in development/revision/use of
RN 4
teaching tools/aids for specific
population within the last year.
It is required to describe specific example(s) for each Key Function. Please enter specific example(s) below:
PROBLEM SOLVING
1. Identifies and takes action to resolve pt
safety related problems and other
clinical issues.
2. Identifies and takes action to resolve
systems (operational/workaround)
problems.
3. Follows appropriate chain of command
when problem solving.
4. Actively participates in team/group
problem solving.
5. Uses interdisciplinary approach to lead
others in problem solving projects and
evaluates outcomes using data.
6. Positively supports change.
Job
Description
Quality/
Expertise
Effect
on
Team
Specific /Example(s) recommended for above level
criteria; especially in support of advancement
RN 1-4
RN 1-4
RN 1-4
RN 1-4
RN 4
RN 1-4
©Nursing Research Office – Vanderbilt Univ. Medical Center
Revised 05/2006
Outpatient Manager Tool
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7. Is a consultant to manager (Ex: clinical,
proposed changes, dept
RN 3-4
enhancements).
It is required to describe specific example(s) for each Key Function. Please enter specific example(s) below:
COMMUNICATION & COLLABORATION
Job
Description
1. Personal behavior positively influences
environment and others (may include
attendance, tardiness, team support).
RN 1-4
2. Accesses HCT to form plan of care/meet
patient’s needs.
RN 1-4
3. Effectively communicates and
collaborates with patients and families.
RN 1-4
4. Effectively communicates and
collaborates with staff and other HCT
members.
5. Communicates positively and
constructively in stressful situations.
6. Provides accurate and objective
feedback in a respectful and
professional manner while maintaining
confidentiality.
7. Completes assigned evaluation tools
within designated timeframe (Ex: end of
orientation, self report, peer feedback).
Quality/
Expertise
Effect
on
Team
Specific /Example(s) recommended for above level
criteria; especially in support of advancement
RN 1-4
RN 2-4
RN 1-4
RN 2-4
©Nursing Research Office – Vanderbilt Univ. Medical Center
Revised 05/2006
Outpatient Manager Tool
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8. Receives peer feedback in a respectful
and professional manner.
RN 1-4
9. Participates directly in and/or supports
orientation of new staff.
RN 2-4
RN 1-4
10. Facilitates internal and/or external
customer satisfaction.
It is required to describe specific example(s) for each Key Function. Please enter specific example(s) below:
Evaluation Scoring Descriptors Effective May 2006
For each criterion, evaluator considers 2 dimensions and chooses only 1 descriptor for each:
ƒ How well the subject performs this behavior, the quality or degree of expertise
ƒ The subject’s effect of the team when performing this behavior
Quality / Expertise
Effect on team
a
Does not perform
a
Unaware or ignores standards and/or direction
b
Performs inconsistently or not to standard
b
Requires much direction
c
Consistently competent = performing to standard
c
Requires some support = what would be expected of a new nurse within their first year
d
Performs independently
consistently
d
Consistently proficient = model performance
exceeding standard with big picture view
Consistently an expert = exceptional, masterful
e
performance, specialist
Benner’s definitions for above descriptors:
•
Competent = uses experience-based practical
knowledge to apply this criteria appropriately
and efficiently while mindful of goals
•
Proficient = has achieved a global “big
e
Role model & resource to others (beyond precepting) = a positive example for others to try to meet;
demonstrates knowledge & expertise that others recognize and go to (outside the preceptor
relationship), personal behavior demonstrates interest in sharing knowledge/expertise with others
f
Initiates informal coaching 1:1 with others (beyond precepting) = Takes opportunities to share
expertise with the intention of facilitating other’s professional development
Isn’t waiting until asked (resource), sees a situation and spontaneously coaches
Revised 05/2006
ƒ
Not telling how, but uses questions, etc. to prompt critical thinking
©Nursing Research Office – Vanderbilt Univ. Medical Center ƒ
Outpatient Manager Tool
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ƒ
picture” perspective, attends to total situation,
proactive
•
g
Expert = highly skilled performance intuitively
knowing what to do and expected results
Random, and persons and topics vary
Facilitates improved group practice = beyond 1:1 individual coaching, does something to improve
the practice group’s performance:
ƒ
In-service
ƒ
Poster, posting, group email
ƒ
Develop or update a standard, protocol, etc.
ƒ
Debrief a critical incident for the benefit of the group present
Formally mentors individuals &/or groups by mutual agreement =
h
Individual
ƒ
Active, personal relationship by mutual agreement focused on specific personal &/or
professional goals
Group
ƒ
Commits to perform an operational or clinical activity or service for a group or practice area,
e.g. chart rounds, competency training, review of policies, pathways, area super-user, etc.
Instructions continued on next/back page
As the evaluator
¾ read each criteria- even above level criteria
¾ choose the 1 descriptor for each of the 2 dimensions that fits best with the subject’s performance of that specific criteria
¾ If above level criteria is not applicable, skip it, do not select any descriptors
The selected descriptors eventually are tallied from all evaluation tools into overall key function scores related to the subject’s RN level
One specific example is required for each key function: Planning & Managing Care, Patient/Family Ed, etc.
For advancement evaluations only: One specific example is required for each RN 3-4 level criteria in addition to key function examples
If one example will cover > 1 criteria or key function, you can refer to it rather than add another
©Nursing Research Office – Vanderbilt Univ. Medical Center
Revised 05/2006