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Performance Management
PGD – HR Spring 2020
Shah M Saad Husain
Case Study - Assignment 4
Email to smsaadh@gmail.com between 9 pm and 10 pm on Friday, April 17
Healthcare Hospitals is a chain which has hospitals in Rawalpindi, Lahore, and Peshawar.
This is a Pakistani, family owned business in the medium class private hospital segment
in the country. The higher class private hospitals are, for example, Aga Khan University
Hospital (Karachi), Tabba Hospital (Karachi), South City Hospital (Karachi), Shifa
International (Islamabad), National Medical Centre (Karachi), City Hospital (Multan),
etc. The lower class hospitals are the government run hospitals.
With increasing population, poor hygiene, pollution, contaminated water and food, rising
illnesses and diseases, and the exponential growth of traffic accidents, especially in the
major cities, the demand for health services in the country is increasing rapidly. Existing
hospitals and clinics are stretched to the limit and it is difficult to reach a competent
doctor or specialist for timely treatment or to get a room in a good hospital.
Healthcare Hospitals are appreciated by patients for their affordable room rates, good out
patient clinics, operation theatres, laboratory, x-ray and diagnostic facilities, and excellent
locations in the city centers near cantonment areas. However, despite these strengths of
Healthcare Hospitals, the number of patients and the profitability of this business have
dwindled in the past 5 years. During 2016, the business could barely break even.
A major problem facing the hospital sector in Pakistan is the acute shortage of trained
staff, medical technicians, especially nurses, maintenance of hospital equipment,
increasing costs of operations, employee grievances and demotivation. Employee
turnover is a serious issue too and is currently estimated at 21% per year at Healthcare
Hospitals.
Healthcare Hospitals are owned by the Hakeem family of Lahore. Dr Naeem Hakeem,
the first generation Hakeem, opened the family’s first roadside clinic immediately after
partition in Rawalpindi Cantt. Dr Naeem Hakeem was a graduate of King Edward
Medical College, Lahore, and apart from running his clinic very successfully; he also
raised a brood of ten children from his two wives. Out of the ten, eight children became
doctors who also married doctors. With the proliferation of doctors in the family and their
very successful clinics, the Hakeems decided to pool their professional and monetary
resources. In 2009, they incorporated the company, Healthcare Hospitals, and proceeded
to set up medium sized, 200-bed hospitals in Rawalpindi, Lahore and Peshawar. The last
hospital, constructed in Peshawar, was commissioned in 2016. Today, the organization
has 980 employees. Although two more hospitals were planned in Multan and Karachi in
2018 and 2019 respectively, these projects have been postponed to 2022 and 2025
because of the setbacks to the business in recent years.
Performance Management – Assignment 4, April 2020
Page 1 of 23
The family has grown further and most key positions in the organization are held by the
Hakeem family’s second generation who now number 28 in the business. Hoshiar
Hakeem is one of those rare Hakeems who are not doctors. Hoshiar has recently
completed his PGD in HR from IBA. Piyari Hakeem, his wife, who is his cousin, is
nevertheless a doctor.
Last week, Hoshiar happened to go to the Healthcare Hospital in Rawalpindi to pick his
wife for a family dinner. As Hoshiar entered the hospital, he received an SMS that Piyari
has to do an emergency gynecological operation to deliver a patient’s baby by Caesarian
Section. Instead of returning home, Hoshiar decided to stay at the hospital and talk to the
Hospital staff. He had always wondered why the business was not doing well and had
heard rumors that employees were unhappy and not sincere to the organization. Having
done the course, Performance Management, during his PGD program, and as the major
gynecological operation was expected to last four hours, Hoshiar quickly made a survey
form and found an opportunity to interact with 50 employees.
The employees’ feedback is both revealing and disturbing. In 4 hours, just by listening to
the Employees Voice, Hoshiar was able to discover various reasons why Healthcare
Hospitals were in dire straits.
1 2 3 4 5
(unacceptable) (poor) (satisfactory) (good) (outstanding)
Salary % 25 45 10 10 5
Benefits % 30 30 20 10 10
Knowledge of Grades and % 40 30 20 5 5
Compensation Structure
Appraisal Process % 20 40 20 10 10
Bonus % 30 40 10 10 10
Annual Targets % 5 15 30 25 25
Competitive Salary % 10 30 20 20 10
Knowledge of Company’s Goals % 5 5 40 30 20
Performance appraisal form % 30 40 15 10 5
Fairness of Appraisal, Increments % 25 25 35 15 5
Training & Development % 40 35 15 5 5
Career Path and Growth % 35 30 30 5 0
Attitude of Management % 20 45 20 10 5
Grievance Handling % 25 45 20 10 0
Timely Increments and Bonuses % 30 30 20 10 10
Motivation to Work % 25 35 20 10 10
Overall Job Satisfaction % 30 45 10 10 5
Current
Salaries
(Rs/month)
6 Jr. Doctors, Accountant, Assistant Managers, Engineer, Head Nurse, Head Laboratory 150 k
Administration and
General Medicine
Personal
Gynecology Nursing
Pediatrics Finance
Orthopedics Procurement
Cardiology Stores
Engineering &
Surgery Maintenance
Physiotherapy
Diagnostics
Radiology
Laboratory
Lack of proper Vision, Mission and Goals has led to ineffective PM at Healthcare
Hospitals.
The main issue at hand is that the current Performance Management System has not been
properly made due and has significant gaps as identified from employee feedback,
The management has revised its existing pay scale for new hires without taking into
account the existing staff performing.
Nor have they established any sound performance evaluation criteria with which
employee yearly performance can be evaluated and reflect thus fails to create
realization of importance of Performance on job and results achieve rather than no.
of years worked in service.
Moreover, there is no there is an absence of communication in current PM. If goals
are to be set they are to be communicated first and to achieve these goals, Means
need to be delivered and ability assed, only then the employee can be held
accountable.
Likewise, in the absence of PM, performance gaps aren’t identified and no
initiatives are taken for improvement of those gaps.
This further leads to demotivation among employees, as no performance is
assessed, star performer is not identified and are not cared for as a result, they start
to believe that organization has not developed any career paths for them.
Not having a comprehensive performance management process which is to be
transparent and accountable in all of its steps, has led to grievances among
employee over unfair increase due to likes and dislikes and managers aren’t being
held accountable for unfair increment.
The PM doesn’t have any goals assigned or communicated to employee and lacks
documentation, if the employee would have known the target and would be aware
of the percentage achieved, then even if he would have had gotten sick, he would
be aware of his performance and would be aware of estimated increment.
Likewise, the manager could not have had done injustice for getting absent as there
would transparency.
PM doesn’t have any performance measurement criteria for assessing performance
of work done by support services and operational departments
PM is failing to provide basic right of respect which employee demands at
workplace and it is their right. As it is not based upon values.
Major problem being no accountability of type of feedback given to junior as well
as the social setting in which the feedback was given.
Question No. 03 Write the Vision, Mission and Corporate Goals of the
organization for 2025 and the impact of the above problems on these Goals.
To become a healthcare provider of choice, by being consistent in delivering quality patient care
and cost-effective services to improve the health status of those who we serve and to strive to
deliver professionalism in our services.
To grow our footprint in the region thus to be a catalyst in improving lives by providing quality
health care through professionalism.
Core Values
People Centricity
Quality Care
Compassion
Corporate Goals
Question No. 04
Design a Performance Management System for the company which will enable
the organization to achieve its 2025 Goals, elaborating the process, procedures,
performance categories, forms, increment and bonus matrix, etc.
Planning
To achieve its Corporate Goals following plan of action would be recommended,
Setting up a Human Resource Department would require and for that HR Manager would be
need of hospital industry.
Plan
Links Corporate Strategic Goals. To every employee’s Performance Goals and Behaviors
HR Manager will be meeting all the Departmental head and briefing them about the Goal for the
coming five years and will assign them the task to submit their role to achieve these goal along
with division of goals according to What & How Targets, in which What targets would to
designated to performance goals, whereas How targets will be related to employee behavioral
competencies
Step 1:
o Identify what you want to achieve. Visualize what will be different afterwards?
Step 2:
o Make it specific. Ask yourself – what do you really need to do?
Step 3:
o Agree some actions. What specific actions need to be taken to achieve the Goal?
o Analyze data for last two years, department/function-wise and position-wise.
o Conduct survey of identified problematic departments/functions and positions and
propose interventions based on findings.
o Implement approved interventions.
Step 4:
o What are the measures? Milestones for the goal help you to test your progress
towards its completion.
A desired output or Series of tasks and activities that Define precisely what is to be
result. It should be a need to be completed during the achieved. They should be
single sentence that performance cycle that will stretching but achievable and
contains an action progress you towards achieving should reflect the expectations of
verb and clear end your performance objective. You the role. Measures may be a
result. actions, act as a progress qualitative or quantitative and
‘checklist’ for your reference objectives may have several
during the performance cycle. different targets to be met.
Core Competencies
o Behaviors critical to all individuals to obtain Company’s strategic objectives
Continuous Improvement
Results Orientation
Teamwork & Collaboration.
Job Specific Competencies
o Behaviors associated with fulfilling responsibilities of a specific job role or task.
o 2-4 additional
Once Goal have been made then Weightage needs to be assigned to them to highlight the level
of importance each goal possess.
Coaching
Performance Management – Assignment 4, April 2020
Page 11 of 23
Once Planning is done, the step of coaching come in to phase, which is a year long process,
Consists of continuous:
o Observing performance
o Documenting Performance
o Giving Feedback on Performance
o Developing for enhanced Performance
o Mid-year or Quarterly review
o Final Review
Performance Management reviews work for up to a year.
Documenting:
o Makes process more accurate and fair
o Progress on SMART Goals and Competencies
o Significant events regarding job performance, + and –
o Performance Log
o STAR Evidence
Feedback
**Feedback on Reward is also necessary, as it motivates the employee to achieve more in life.
Review
(b) (d)
Weighted Weighted
Performance (a) Supervisor Behavioural (c) Supervisor
Rating Rating
Goal # Weighting Rating Competency # Weighting Rating
(a) x (b) (c) x (d)
(1,2,3) (1,2,3)
1 1 20%
2 2 20%
3 3 20%
4 4
5 5
6 6
7 7
TOTAL Performance
TOTAL Competency Rating
Goal Rating
(50%) (50%)
• The supervisor discusses with employee their actual achievement against the goals &
competencies based on the facts and evidence presented in each one’s Performance Logs
Name P. No.
Title Location
Review Period Supervisor
Mid-Year Review
Supervisor Name and Signature (both, if applicable, Functional & Administrative): Date:
(50%) (50%)
2.60 – 3. 00 Excelling – “3”
OVERALL PERFORMANCE
1.50 – 2.59 Performing – “2”
RATING (100%) Final Performance Review
Up to 1.49 Partially Performing – “1”
Administrative Supervisor Name and Signature: Date:
Partially Jobholder did not consistently meet (<75%) expectations for Performance Goal and/or Behavioral
1
Performing Competency.
2 Performing Jobholder has achieved 75% - 125% of expectations for Performance Goal and/or Behavioral Competency.
Jobholder has consistently exceeded (>125%) expectations for Performance Goal and/or Behavioral
3 Excelling
Competency.
TOTAL 100%
TOTAL
Behavioral Competency Weightin
MID-YEAR REVIEW FINAL REVIEW
Identify 5 to 7 Competencies for this
Performance Management Cycle
g
100%
Actual Actual
Ratin Ratin
Refer to the Competency Dictionary for (min Achievement g Achievement g
additional Core & Job Specific 10%, As supported by As supported by
competencies and the behavioural max Performance Log PP (1) Performance Log PP (1)
indicators 30%) P(2) P(2)
E(3) E(3)
What issues will be faced by Hoshiar with the Company’s owners, management
and staff while introducing a professional Performance Management System?
How should he handle these issues?
Issues by Owner,
Issues by Management
Would not want to give-up their preferences in providing increments on likes and
dislikes.
Will have to prove their objectives and give results based on goals rather than daily
operations.
Issues by Staff
Handling Issues
For Owners,
Provide them quantitative feedback on positive side of PMP,
Control over Overstaffing
Increase in Profits
Better Patient Care
For Management,
Better Increment for good performance.
Bonus for greater profits
For Staff
Training them for the new process
PLAN
Discussion
Draft Performance and Behavioural
Goals cc HR TNA
Agree B-Personal Development
Plan
Manager & Employee Sign-off
Jul-Aug
Conduct Mid-Year Review Activated by HR