Chapter 9: Project - Create Employee Performance Appraisal Form

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Employee Performance Appraisal Form

What is an appraisal form:

An appraisal form is a document that is created by the HR or manager and is used to evaluate the employee on their performance. The form will include different areas for rating and leaving comments. On an appraisal form, managers keep track of employees' achievements and contributions during a specific period. It will indicate the employees areas of strength and weakness.

Department leads/Managers will use the document to guide them through an employees performance review by highlighting specific items to discuss.

How to create an appraisal form:

A strong and reflective performance appraisal will help both the employer and employee. It will show where the employee is excelling and where they need improvement.

Here are items that should be included when creating an appraisal form:

1. Choose specific traits and tasks to be evaluated. (Need to be job specific not generic)

2. Needs to have a specific rating rubric. (explain the rubric with proper instructions)

EXAMPLE:

• 1 = Poor (consistently fails to meet expectations)
• 2 = Fair (frequently fails to meet expectations)
• 3 = Good (usually meets expectations)

3. It must show or highlight employee's achievements.

4. It must show how employee can improve.

5. Include previous reviews or future goals to be reviewed at the next performance review.

6. Give opportunity for employee to comment and show that it was reviewed with employee. (This could be written in questions that gives employee opportunity to respond or check box and signature that both supervisor and employee reviewed the document together)

Your Textbook mentions these requirements:

5 items that are usually found on a performance appraisal form.

• Job performance standards that measure both qualitative and quantitative aspects of job specific responsibilities
• Individual employee goals that were written at the previous annual performance evaluation along with progression toward meeting those goals
• Employee values that match the mission and vision of the organization and a rating of how the employee performs in relation to these values
• Self-appraisal of the employees performance may be included
• Feedback from coworkers on the employees performance

Find ideas and do research online to get better understanding of the performance appraisal form.

• Make sure the form has a line or area for Employee's information: name, department, supervisor name, date, objectives and ratings, achievements, areas of improvement, professional goals, employee comments, and space for signatures.

Resources and Instructions

You are given a task to create Employee Performance Appraisal Form for either of these positions attached below.

Supervisory Medical Records Technician- Release of Information (ROI)

US Veterans Health Administration

(part of U.S. Government)

3710 SW US Veterans Hospital Rd, Portland, OR 97239

$55,477 - $72,125 a year - Full-time

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Job

Company

Job details

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Pay

$55,477 - $72,125 a year

Job Type

Full-time

Duties

The Supervisory Medical Technologist (ROI) duties include, but are not limited to:

• (Leadership) Serves as supervisor and technical expert for the Release of Information Unit.
• (Leadership) Provides guidance and suggestions to the Chief, HIM and Assistant, Chief HIM regarding staffing needs and shortages within the ROI section.
• (Monitors) Provides effective audits and monitors for all areas of responsibility, assuring that accurate and timely data is processed by all employees.
• Reviews work accomplished and assesses quality, quantity, accuracy and timeliness of work produced by each employee.
• Ascertains problems encountered and takes corrective action.
• Develops performance standards and conducts performance evaluations.
• Develops and conducts competency assessments.
• Responsible for carrying out established personnel functions and practices.
• Keeps employees informed about important aspects of personnel management programs.
• Formulates and initiates performance standards.
• Interviews new employees, recommends selection, and carries out training and development of assignments, awards or disciplinary action.
• Approves leave and establishes work schedules.
• Implements provisions of EEO programs to ensure fair and equal treatment for all employees.
• Prepares formal requests and recommendations for promotions, reassignments, other status changes, or recognition of outstanding performance of assigned employees.
• Prepares and submits functional statements for new positions, clarification, or updates.
• Takes disciplinary action as deemed necessary and proposes to higher authority specific disciplinary action.
• Keeps employees informed of management goals and objectives and higher levels supervisors informed of employee participation and concerns.
• Ensures that release of information activities related to the development, implementation, maintenance of and adherence to privacy policies and procedures are performed and coordinated in compliance with applicable federal laws and regulations including the Privacy Act of 1974, the Freedom of Information Act (FOIA), the Healthcare Insurance Portability and Accountability Act (HIPAA) and Automated Medical Information Exchange (AMIE).
• Ensures that record retrieval and record transfers to other VA facilities for the purposes of continuity of patient care and release of information are timely.
• Maintains contact with VA Regional Counsel (VARO) in all matters relating to malpractice, subpoena actions and request for preparation of TORT records.
• Assist in performing 100% quality review of all TORT cases prior to sending records to VARO for litigation.
• Prepares weekly ROI and TORT record turnaround statistics.
• Monitors workload and production of staff, taking action where necessary to meet deadlines, monitors/evaluate performance and ensures accuracy of work completed.
• Assures that the work of staff is at an appropriate quality and productivity level.
• Interviews new employees, recommends selection, and carries out training and development of assignments, awards or disciplinary action.

Work Schedule: Monday-Friday, 7:30 am - 4:00pm Compressed/Flexible: Not Available Telework: Available at supervisors discretion. Virtual: This is not a virtual position. Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Fi nancial Disclosure Report: Not required

Requirements

Conditions of Employment

• You must be a U.S. Citizen to apply for this job.
• Selective Service Registration is required for males born after 12/31/1959.
• Must be proficient in written and spoken English.
• You may be required to serve a probationary period.
• Subject to background/security investigation.
• Selected applicants will be required to complete an online onboarding process.
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
• Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See "Additional Information" below for details.
• Successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit e-verify.gov

Qualifications

Basic Requirements:

• United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• English Language: Must be proficient in spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d).
• Experience and Education: one year of creditable experience that indicates knowledge of medical terminology and general understanding of health records. Six months of the required one year of creditable experience must have provided the knowledge, skills, and abilities (KSAs) needed to perform MRT (ROI) work. OR
• Education: an associate's degree from an accredited college or university recognized by the U.S. Department of Education with a major field of study in health information technology/health information management, or a related degree with a minimum of 12 semester hours in health information technology/health information management (e.g., courses in medical terminology, anatomy and physiology, legal aspects of health care, and introduction to health records). OR
• Experience/Education: equivalent combinations of creditable experience and education are qualifying towards meeting basic experience requirements. The following experience and educational/training substitutions are appropriate for combining education and creditable experience:
• (a) Six months of creditable experience that indicates knowledge of medical terminology, privacy and release of information, the health record, and one year above high school with a minimum of six semester hours of health information technology/health information management courses. (b) Six months of creditable experience that indicates knowledge of medical terminology, privacy and release of information, the health record, and successful completion of a course for medical technicians, hospital corpsmen, medical service specialists, or hospital training obtained in a training program given by the Armed Forces or the U.S. Maritime Service under close medical and professional supervision. The training program may be substituted on a month-for-month basis for up to six months of experience provided the training program included courses in anatomy and physiology, and health record techniques and procedures.

Grade Determinations- GS-8 In order to qualify for the GS-8 Supervisory Medical Records Technician (ROI) you must possess one full year of experience equivalent to the next lower grade level (GS-7). In addition you must also demonstrate the following Knowledge, Skills, and Abilities: (a) Ability to develop policy and provide workload analysis for release of information. (b) Skill in interpersonal relations and conflict resolution. (c) Ability to provide or coordinate staff development and training. (d) Ability to provide the full range of supervisory duties, to include responsibility for assignment of work to be performed, performance evaluation, selection of staff, recommendations of awards, advancements, and disciplinary actions. Preferred Experience: Supervisory Experience