Nurses' perspectives towards the introduction of a Performance Management Programme in a public hospital : a case study in St. Luke's Hospital.

Abstract

The study used an exploratory descriptive design to obtain a comprehensive picture of the nurses' perspectives towards the introduction of a Performance Management Programme in a Maltese public hospital. The study sought to determine nurses' views towards statements that could reflect the need for such a programme at their workplace, hindering and facilitating factors towards its introduction and issues concerning the performance assessment. Moreover, the nurses' current situation with regards to support and training to ameliorate indivldual performance at work was also assessed. The President of the Malta Union of Midwives and Nurses (MUMN) and senior officials from the Office of Prime Minister and Health Division, were personally contacted so as to discuss their perspectives towards such a programme. A fully structured questionnaire, which was purposely constructed to fulfil the objectives of this study and measured perspectives on a 4-point Likert Scale, was distributed to a random sample of full-time shift nurses working in general and specialised wards within the hospital. A response rate of 93.4% (n=152) was obtained. Quantitative analysed data revealed that the vast majority of the nurses agreed that they would like to discuss work related problems, to receive support and guidance, to receive feedback on how they are doing and to know what is expected from them. However, Chi Square analysis revealed that the level of agreement or disagreement towards having a supervisor at work significantly depends on the nurses' age (p=0.007<0.05). It appears that there is agreement amongst nurses, that the Nursing Officer should be primary involved in their performance assessment and would like such a programme to be linked to training and development needs rather than to pay, although this strongly depends to nurses' level of education (p=0.002<0.05). Nurses are in agreement that such a programme is time consuming but not a waste of time whilst they regard it to be unfair and can lead to personal criticism. Recommendations and implications for management include the implementation of an appropriate change strategy towards a people-oriented culture where there is support for individual performance at work, decentralisation of the management of individual performance at ward level and involvement of all stakeholders towards the introduction of the Performance Management Programme. The main suggestions for further research include the exploration of managerial perspectives through the use of interviews or focus groups, as well as identifying a pilot ward where such programme will be designed, implemented and evaluated prior to allowing its penetration throughout all the hospital.