360 Performance Assessment Tool – Leadership
I, (Associate name)Diana Ellison am seeking your input in preparation for my performance assessment. Please be as candid and constructive as possible. I will receive a summary of the results, not your actual scores and comments. All responses will be kept confidential. Thank you for your feedback.
Please return to the completed form to, (Supervisor’s name)Hazel Robertshaw, CNO by, (date)8.26.11
Please assess the following:
Organizational Competencies
/Performance Standards
/Comments
Leadership Exceptionally Developed
Fully Developed
Opportunity for Further Development / Serves as a role model for clinical practice and establishes an environment to facilitate development of all nursing practice. Acts as a resource to Nursing Councils. / Diana has a strong sense of self and seems comfortable in her leadership role. She is constantly questioning and researching areas that would benefit the development of nursing practice.
Management / Fiscal Responsibility / Financial Management
Exceptionally Developed
Fully Developed
Opportunity for Further Development / Manages educational programs and quality improvement projects as required. Monitors outcomes of project work and identifies opportunities for improvement / Diana is spearheading the nurse-driven Foley catheter removal program and was able to secure our NICHE designation. She is constantly monitoring and searching for opportunities to improve on processes that would benefit not only the nursing staff, but the patients as well.
Quality Processes
Exceptionally Developed
Fully Developed
Opportunity for Further Development / Consistently seeks the generation of new ideas and fosters collaborative relationships with interdisciplinary teams to drive improvements in patient care / Diana is continuously looking at collaboration not only between units in the hospital, but between hospitals to fully foster relationships that could benefit the outcome of the patient. Diana’s work with NICHE has solidified her collaborative work with local hospitals and in turn provided valuable information to our team to help drive improvements in patient care.
Customer Satisfaction/Results/Outcomes
Exceptionally Developed
Fully Developed
Opportunity for Further Development / Develops programs designed to improve the patient experience and monitors outcomes against agreed goals / Diana is relentless in her quest to improve patient outcomes; even monitors UTI/Foley logs on each unit to make sure all Foleys are tracked so correct information can be documented in her CAUTIS research component.
Developing Associates
Exceptionally Developed
Fully Developed
Opportunity for Further Development / Provides opportunities for nurses to develop critical thinking and advanced clinical skills across the department of nursing. / Helps maintain a positive working environment by serving as resource for staff and setting positive tone on all units.
Evidence-based comments (please use specific examples):
Identified Strengths:
Diana is very dependable and was a valuable resource when trying to find my way around the hospital. Diana has always brought thoughtful questions to the nursing council meetings and is very thorough when creating/researching information. She is very approachable and is seen by the nursing staff as an excellent resource.
Opportunities for Development:
Presenting our information to the wider community
Other Comments:
Developmental Continuum Key:
Exceptionally Developed: Viewed as the consummate professional by others in this area. S/he is viewed as a towering strength in a particular area being evaluated and can teach others. Exudes positive influence.
Fully Developed: Accurately and efficiently completes tasks in a timely manner. May benefit from occasional guidance, supervision or direction.
Opportunity for Further Development: May demonstrate strength in a particular area and the strength can be developed further OR demonstrates inconsistent performance and requires more guidance than would be expected based on level of education and on the job training received.
C:\DOCUMENTS AND SETTINGS\ROBEHA\MY DOCUMENTS\LEADERSHIP\EVALUATIONS\NURSING ADMIN\2011\DIANA\360 CNL 8-10(2).DOCRev. Date: 11/04/2018