PRESENTED BY: GRACE ALEXANDER MSc II YEAR

1. Seminar On DISCIPLINE, PEER AND SELF EVALUATION PRESENTED BY: GRACE ALEXANDER MSc II YEAR

2. INTRODUCTION

3. TERMINOLOGIES • Appeal: Making an earnest or formal request • Arbitration: An impartial judgment given to settle a dispute • Code of conduct: A code of conduct is a set of rules outlining the responsibilities of or proper practices for an individual or organization. • Collegiality: Relationship between colleagues • Demotion: Reduce to a lower rank or category

4. Dismissal: Send away or reject from a position or employment • Emolument: A fee or salary • Misdemeanor: A misdeed or a wrong doing • Penalty: Punishment for breaking a law, rule or contract • Reprimand: Rebuke • Restitution: The restoring of a thing to its proper owner or original state; a compensation. • Suspension: Deprive temporarily of a position or right

6. DEFINITION • Discipline is defined as a training or moulding of the mind and character to bring about desired behaviours. • Discipline refers to working in accordance with certain recognized rules, regulations and customs, whether they are written or implicit in character.

7. AIMS AND OBJECTIVES OF DISCIPLINE The aims and objectives of discipline are: • To obtain a willing acceptance of the rules, regulations and procedures of an organization so that organizational goals can be achieved. • To impart an element of certainty despite several differences in informal behavior patterns and other related changes in an organization

8. To develop among the employees a spirit of tolerance and a desire to make adjustment • To give and seek direction and responsibility • To create an atmosphere of respect for the human personality and human relations • To increase the working efficiency and morale of the employees so that their productivity is stepped up, the cost of production brought down and the quality of production improved.

9. PRINCIPLES OF DISCIPLINARY ACTION • Have a positive attitude • Investigate carefully • Be prompt • Protect privacy • Focus on the act • Enforce rules consistently • Be flexible • Advise the employee • Take corrective, consistent action • Follow up

10. COMPONENTS OF A DISCIPLINARY ACTION PROGRAM 1. CODES OF CONDUCT: The employees must be informed of codes of conduct. Agency handbooks, policy manuals, and orientation programs may be used. Eg. Employee code of conduct. 2. AUTHORISED PENALTIES: The agency’s disciplinary action program should indicate that the current action is being administered without bias and is directly related to the offense.

11. 3.RECORDS OF OFFENCES AND CORRECTIVE MEASURES: The personnel record should clearly indicate the offense, management’s efforts to correct the problem and the resulting penalties. 4. RIGHT OF APPEAL: Formal provision for right of employee appeal is a part of each disciplinary action program.

12. EMPLOYEE CODE OF CONDUCT • The basic pre-requisite for effective discipline is employee awareness of agency rules and regulations governing employee behaviour. • Behaviour rules should be written in clear and concise language, incorporated in a hand-book and given to new employees during induction, posted in each work unit and discussed with employees by manager of each unit.

13. The significance of code of conduct is that each employee should behave and perform in a way that preserves the company values and commitments.

14. PENALTIES • Oral reprimand: • minor violations , for the first time, managers may opt give an oral warning in private • an anecdoctal record of time, place, occasion and gist of the reprimand. • Written reprimand: • more severe or repeated offense • written notice should include name of employee and manager, nature of problem, plan for correction, and consequences of future repetition. • employee has to sign it, to indicate that the employee has read it. A copy should be given to the employee and one retained for the personnel file.

15. Other penalties: • Fines for offences such as tardiness. • Loss of privileges - transfer to a less desirable shift and loss of preference for assignments. • Demotion is a questionable solution. It creates hard feelings which may be contagious and more likely places offenders in a position for which they are overqualified. • Suspension • Withholding increment • Termination(dismissal): permanent termination of services.

16. APPROACHES OF DISCIPLINE

17. TRADITIONAL APPROACH • It emphasizes punishment for undesirable behaviour. • The purpose of traditional approach is to punish for sin, enforce conformity to custom, and strengthen authority of the old over the young. • Here discipline is always applied by superiors to subordinates, the severity of punishments is designed to be proportional to the severity of the offense, and when no single individual admits to the violation, the whole group is punished to motivate group members to identify the violator or punish him or her themselves

18. DEVELOPMENTAL APPROACH • It emphasizes discipline as a shaper of desirable behavior. • The purpose of developmental discipline is to shape behaviour by providing favourable consequences for the right behaviour and unfavourable consequences for the wrong behavior; and avoidance of physical punishment, protection of the rights of the accused and replacement of arbitrary individual judgements of guilt.

19. POSITIVE DISCIPLINE APPROACH • It is based on the assumption that an employee with self-respect, respect for authority, and interest in the job will adhere to high quality work standards; and when an interested, respectful and self-respecting worker temporarily strays from his/ her usually highs standards, a friendly reminder is enough to redirect their efforts in the desired direction • Organisations that have employed a positive discipline have noted a subsequent decrease in absences, dissmisals, disciplinary actions, grievances and arbitration, along with improvement of employee morale.  

20. SELF CONTROLLED DISCIPLINE APPROACH • The employees bring his or her behaviour into agreement with the organisationsbehavioural official code i.e. the employees regulate their own activities for the common good of the organisation. ENFORCED DISCIPLINE APPROACH • A managerial action enforces compliance with organisations’ rules and regulations ie. it is a common discipline imposed from the top. Here the manager exercises his authority to compel the employees to behave in a particular way.

21. SELF DISCIPLINE • It refers to one’s effort at self-control for the purpose of adjusting oneself to certain needs and demands. This form of discipline is based on two psychological principles. • First, punishment seldom produces the desired results. Often, it produces undesirable results. • Second, a self-respecting person tends to be a better worker than one who is not.

22. CONSTRUCTIVE VS DESTRUCTIVE DISCIPLINE • Constructive discipline (positive discipline) uses discipline as a means of helping the employees grow, not as a punitive measure. • The primary emphasis here is assisting employees to behave in a manner that allows them to be self-directive in meeting organizational goals. • Destructive discipline (also called enforced or negative discipline): If employees are forced to follow the rules and regulations of the organization by inducing fear in them, then it is termed as negative discipline

23. DEALING WITH DISCIPLINARY PROBLEMS • DISCIPLINARY CONFERENCE • DISCIPLINARY LETTER • MODEL STANDING ORDERS • ERRORS IN DISCIPLINIG EMPLOYEES

24. DISCIPLINARY CONFERENCE • It is a group discussion using both directive and non-directive interview techniques. • It is damaging to employee’s self-esteem to receive criticism from an authoritative figure. Thus a disciplinary conference is anxiety provoking situation for both employee and the manager.

25. DISCIPLINARY LETTER • It is a letter send to the nurse/employee immediately after the conference, documenting the interview content from the managers viewpoint. • It is needed as sometimes employee’s anxiety may block perception of the painful feedback offered by the manager. MODEL STANDING ORDERS • It specifies the terms and conditions which govern day to day employer-employee relationship, infringement of which could result in a charge of misconduct.

26. ERRORS IN DISCIPLINIG EMPLOYEES The frequent errors encountered while disciplining the employees are: • Delay in administering discipline • Ignoring rule violation in hope that it is an isolated event • Accumulations of rule violations, causing irritated manager to “blow up” • Administering sweetened discipline • Failure to administer progressively severe sanctions • Failure to document disciplinary actions accurately • Imposing discipline disproportionate to the seriousness of the offense • Disciplining inconsistently

27. General Civil Services Rules • The essence of Government service is the sense of discipline to which all Government employees are subject and it is related to the employees code of conduct and discipline. • Article 311 of the constitution enumerates two fundamental principles upon which the whole procedural law concerning departmental punishments on civil servants rests.

28. The first clause of the article contains the guarantee that no civil servant shall be dismissed or removed by an authority surbordinate to that by which he was appointed. • The second clause guarantees to him a reasonable opportunity of defence on the charges against him, supplemented by a second opportunity of showing cause why such a punishment should not be imposed on him, if after enquiry it is proposed to dismiss or to remove or to reduce him in rank.

29. Only the appointing authority can impose major punishment (dismissal, removal or reduction in rank). The power of punishment can never be delegated. • Enquiry officer is a officer subordinate to the appointing authority; who conducts formal enquiry about the charges on the charged official. The enquiry report contains findings of the charges, but there should be no recommendations about the punishment.

30. CAUSES OF DISCIPLINARY PROCEEDINGS • Acts • Acts amounting to crimes • Eg. Bribery, corruption • Acts amounting to misdemeanor • Eg. Misbehavior, insurbordination, disobedience • Acts amounting to misconduct • Eg. Violation of conduct rules or standing orders • Omissions Eg. Habitual late attendance, irresponsibility, negligence.

31. STAGES OF DISCIPLINARY PROCEEDING ENQUIRY • Preliminary enquiry • Decision to start formal departmental enquiry • Suspension • Charge sheet and its service • Appointment of enquiry officer • Written statement of defence • Recording of evidence by the enquiry officer • Personal hearing of charged official

32. Report of enquiry officer • Show cause notice by the disciplinary authority • Reply to show-cause notice and decision thereon • Review of punishment order • Appeal or revision • Reinstatement and restitution • Show-cause notice against withholding of emoluments for suspension period in the case of a reinstated.

34. EVALUATION DEFINITION • “It is an act or process that involves the assignment of a numerical index to whatever is being assessed” • “Evaluation is an act or process that allows one to make a judgement about the desirability or value of a measure”

35. SELF EVALUATION DEFINITION • Self evaluation is defined as judging the quality of one’s work, based on evidence and explicit criteria, for the purpose of doing better work in the future.

36. PURPOSES OF SELF EVALUATION • To encourage continuing self- reflection and to promote an ongoing, innovative approach. • To encourage individual professional growth in areas of interest to the employee • To improve morale and motivation by treating the employee as a professional in charge of his or her own professional growth. • To encourage collegiality and discussion about practices among peers in an organisation • To support employees as they experiment with approaches that will move them to higher levels of performance

37. BENEFITS OF SELF EVALUATION • Increased confidence in their own learning, in trying out new ideas, in changing their practice and in their power to make a difference. • Enthusiasm for collaborative working, despite initial anxieties about being observed and receiving feedback • Improved team-work and greater flexibility in their use of their skills • Increased awareness of new techniques and greater insight into thinking • Enhanced planning skills to ensure more effective task management.

38. TOOLS FOR SELF EVALUATION • Staff annual professional review procedures • Peer support • Coaching • Joint preparation of materials • Planning • Team building • Observation can involve experts, can be informal or formal procedures. Feedback from such observation is very valuable, but must be handled sensitively • Audit checklist

39. PEER EVALUATION DEFINITION • Peer review is a process by which employees of the same rank, profession, and setting evaluate one another’s job performance against accepted standards. - O’ Loughlin and Kaulbach

40. THE SUCCESS OF PEER EVALUATION DEPENDS ON • Short but objective method • Trained observers • Constructive feedback for faulty development • Open communication and trust

41. METHODS OF PEER EVALUATION • Direct observation • Videotaping • Evaluation of course materials • Analysis of portfolios

42. PROCESS OF PEER REVIEW • Establish a policy requiring peer reviews • Establish criteria for peer evaluations • Procedure for conducting peer evaluations • Faculty chosen to conduct peer evaluations shall be tenured and hold on academic rank higher than that of the faculty member being evaluated • A written report, addressing the criteria, shall be prepared and signed by the evaluator -contd…

43. The department shall archive the written evaluations for use in future evaluations • One copy of the peer evaluation shall be placed in the permanent personnel file of the person being evaluated • All reports of peer evaluations shall be included in the tenure file, and are to be carefully reviewed at the department.

44. PATIENT SATISFACTION DEFINITION • “Patient satisfaction is defined as a health care recipients reaction to salient aspects of the context, process, and result of their service experience.” - Pascoe (1983) • “Patient satisfaction is defined as the extent of the resemblance between the expected quality of care and the actual received care.” - Scarding (1994)

45. NEED FOR EVALUATING PATIENT SATISFACTION • Data about patient satisfaction equips nurses with useful information about the structure, process and outcome of nursing care. • It is a requirement for therapeutic treatment and is equivalent to self therapy. Satisfied patients help themselves get healed faster because they are more willing to comply with treatment and adhere to instructions of health care providers, and thus have a shorter recovery time.

46. METHODS OF MONITORING PATIENT SATISFACTION • Medical audit • Quality assurance committee reviews • Indices of nursing performances • Judgemental method

47. COMPONENTS OF EVALUATION OF PATIENT SATISFACTION It involves evaluation of: • The programs and activities of various departments including outpatient care, inpatient care, overall health education activities of the hospital • The various resources available in the hospital for effective health care • Effectiveness of hospital personnel including medical, paramedical, nursing as well as non-medical employees of the hospital. • Services are relevant to the needs of the population it serves.

48. ULITILISATION REVIEW MEANING • The utilisation review program includes determining appropriate hospital length of stay and necessary treatments for various illnesses and conditions and reviewing patient medical records on admission and at intervals during hospitalisation to ensure that the patient receives appropriate care.

49. AIMS AND OBJECTIVES: • The main aim is to curb the exploding health care costs with conservative use of hospitalisation and expensive diagnostic and treatment procedures. • They work in liason with a business organisation to provide healthcare services to the organisation’s employees at discounted rates. • Cost containment to limit each patient’s diagnostic and treatment measures to the fewest, least expensive procedures that will relieve patient symptoms, avert costly complications, and return the patient to fullest possible function in the shortest time possible.

50. UTILISATION REVIEW NURSE • A registered nurse who reviews individual medical cases to confirm that they are getting the most appropriate care. • They can work in hospitals and also insurance companies, determining whether or not care should be approved in specific situations. • Members of this profession do need to possess compassion, but they also need to be able to review situations dispassionately to make decisions which are fair, even if they may be uncomfortable.