Performance assessment in health care providers: a critical review of evidence and current practice.
OBJECTIVE
To evaluate methods of performance assessment through an international literature review and a survey of current practice.


BACKGROUND
Over the past two decades health care organizations have focussed on promoting high quality care in conjunction with retaining motivated staff. Cognisant of such initiatives, we sought to evaluate assessment methods for qualified staff according to their utility in the working environment.


METHODS
A systematic literature search was completed and each paper independently reviewed. All health care organizations in Northern Ireland submitted details of their performance assessments. Each was critically appraised using a utility index.


RESULTS
Performance was not universally defined. A broad range of assessments were identified, each method had advantages and disadvantages. Although many lacked rigorous testing, areas of good practice were also noted.


CONCLUSIONS
No single method is appropriate for assessing clinical performance. Rather, this study endorses proposals for a multi-method strategy to ensure that performance assessment demonstrates all attributes required for effective nursing and midwifery practice.
Hamilton
Karen E Stc
KE
National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK. karen.hamilton@npeu.ox.ac.uk
Coates
Vivien
V
Kelly
Billy
B
Boore
Jennifer R P
JR
Cundell
Jill H
JH
Gracey
Jacquie
J
McFetridge
Brian
B
McGonigle
Mary
M
Sinclair
Marlene
M
D054869:Clinical Audit; D002983:Clinical Competence / Q000592:standards*; D003362:Cost-Benefit Analysis; D004282:Documentation; D004650:Employee Performance Appraisal / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D030141:Feedback, Psychological; D006281:Health Occupations / Q000193:education / Q000592:standards*; D006801:Humans; D020380:Needs Assessment; D009660:Northern Ireland; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009745:Nursing, Supervisory; D019370:Observation; D010348:Patient Care Team; D011594:Psychometrics; D036301:Qualitative Research; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012107:Research Design; D012647:Self-Assessment; D011795:Surveys and Questionnaires