RESUMO
INTRODUCTION: Evaluating employee performance is important for organisational success however, limited research exists across the allied health workforce. OBJECTIVE: This study investigated allied health clinician and manager experiences and perceptions of the appropriateness of the performance and development (PAD) framework. DESIGN: A mixed methods design with purposive sampling was conducted in a medium size hospital and health service in regional Queensland to investigate the appropriateness of the PAD framework. A 29 item online survey collected likert scale and open ended responses. Identified respondents also completed a semi-structured interview. Aggregated satisfaction scores identifying PAD alignment, processes, education, resources and perceptions were analysed to identify organisational PAD appropriateness. Themes from interviews provided concurrent experiential data. FINDINGS: Eighty-five respondents completed the online survey and 20 interviews were conducted. A Chi-Square Goodness of Fit test revealed a significant (p < 0.05) clinician (n = 75) response of moderate dissatisfaction (36%) for the PAD framework, while managers (n = 10) were neither dissatisfied nor satisfied (50%) or moderately satisfied (40%). Clinician aggregated agreement responses were significantly (p < 0.05) higher for PAD alignment (45%), processes (63%), education (49%) and lower for feedback (33%) and resources (28%). Manager aggregated agreement responses were high for PAD alignment (85%), processes (55%), education (57%), feedback (65%) and perceptions (50%). Interviews (n = 20) revealed three themes: uncertainty around PAD framework; expectations for experienced leadership and importance of discipline specific knowledge. DISCUSSION: This study draws on both clinician and manager input to assess the overall PAD framework with responses favouring clinician dissatisfaction to the current process. CONCLUSION: The PAD framework is valuable for staff development when there is positive rapport and discipline alignment between both clinician and manager. Successful staff appraisals require efficient and appropriate documentation that promotes individual development, clinical performance and organisational priorities.
Assuntos
Pessoal Técnico de Saúde, Serviços de Saúde, Humanos, Queensland, Liderança, Atenção à SaúdeRESUMO
OBJECTIVES: There is a paucity of information on the prevalence and clinical implications of malnutrition in patients hospitalised for management of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). This study aimed to fill this gap in knowledge. METHODS: We performed a retrospective observational cohort study of 100 hospitalised AECOPD patients. The Malnutrition Screening Tool (MST) was used to identify patients at risk of malnutrition (MST ≥2). Patient characteristics, length of stay, readmission rate, 12-month survival and overall survival were collected using a proforma. RESULTS: MST scores were available in 90 patients, of whom 22% of patients had a MST score of ≥2. There were no significant differences in COPD severity, treatment received and biochemical parameters between the groups of patients 'at risk of malnutrition' and those 'not at risk of malnutrition'. Length of stay in hospital was longer in patients 'at risk of malnutrition' (median (IQR): 3.5 (2-7.5) vs. 3.0 (1-5), p = 0.048). Overall survival was significantly reduced in patients with 'at risk of malnutrition' compared to those patients 'not at risk of malnutrition' (337 ± 245 vs. 670 ± 292, p < 0.001). CONCLUSIONS: Using the MST we found that one-fifths of our hospitalised AECOPD patients are at 'at risk of malnutrition'. Moreover, this cohort of patients had worse outcomes both during and extending beyond hospitalisation compared to patients 'not at risk of malnutrition'. Our study illustrates the need for routine malnutrition screening for hospitalised AECOPD patients because it has implications for potentially reducing morbidity and mortality in COPD.
