An evaluation of the performance management system within ten public health institutions of the Free State Province

Abstract

This research study was undertaken, primarily, to establish the major factors which influence the effectiveness Jf the employee performance management and development system (EPMDS) to deliver its intended purpose within the Department of Health in South Africa. That is, why the EPMDS has largely been ineffective in achieving intended organisational goals and objectives. That entailed undertaking a critique of a substantial literature study about performance appraisals issues, to ensure that only relevant ones were incorporated in the development of a theoretical (normative) model to address the research problem. In addition, personal interviews were conducted with selected hospital staff, which included top, middle and lower management and junior staff in order to augment, evaluate and reiterate the theoretical findings. The literature from journals, publications, articles of decades of research reviewed established gaps, which compromised the effectiveness of the EPMDS. Key driving factors - determinants were identified and well addressed in the study to enhance its success in achieving intended purpose. A number of models contributed enormously to the foundation of the normative model, which included, Boyatzis' (2082) effective management model, Quinn's (1988) competing values framework, the four perspectives balance scorecard of Kaplan and Norton (1996), and Leadership Code of Ulrich et al. (2008). It was established, however, in the literature review, that leadership and management were focusing more on rewarding the high performers or favourites and reprimanding the low-performers or the outer group than other objectives, - proficient leadership, effective management and employee empowerment through training and development. This acted as blockage to the attainment of these and other objectives, like leadership succession, employee performance sustainability, personality traits, enhanced coordination and control within the organisation, improved goal alignment between the organisation and its members, and increased employee effort, and commitment. The study was conducted on employees of the ten public hospitals within the Free State Province of salary levels 1-12, for whom the EPMDS was applicable. The target population was about 2400 employees, from whom a target sample of 300 were selected, comprising of CEO's (as leaders), managers and employees. The research study was qualitative, which entailed collecting data by means of self-administered structured questionnaires from the sample. In addition, interviews were conducted on 65 employees of the target sample to improve and validate the quality of data collected. Consequently, the research design was a triangulation of quantitative and qualitative methods to ensure reliability and validity. Thus, different methods of data collection were used, such as questionnaire and interviews, which were employed to garner the perceptions or opinion of employees on certain key aspects of performance appraisals. Simple random sampling was employed for selecting 300 participants from 2400 employees, whilst and purposive-judgemental method used for identifying the participants of the interviews, to ensure that the empirical testing of the hypotheses is achieved. This study was undertaken with regard to a number of limitations. First, the target population might not have been representatives of all the public health employees in South Africa, as the research was conducted in only ten institutions in one province. Another limitation was that respondents to questionnaires might have rated their hospital more favourable than an outsider would have. Finally, there might have been other factors or dimensions, which might have impeded the EPMDS effectiveness that might not have been included in the research design. Evidence, however, emerged that supported the existence of six key construct with a total of twelve major determinants that influenced the effectiveness of performance appraisals to develop and empower all stakeholders to provide quality service to the community, whilst meeting executive, political and personal needs and deadlines. The constructs were established as leadership, administration, development, information, management competency and moderation. The determinants were identified as leadership process, performance culture/climate, selection and placement of talents, alignment of potentials/skills with organisational goals, communication, management of appraisals, motivation, expectations, resources, responsibility and accountability, acknowledgement of performance, and diversity in the workplace. A strong link was established between these determinants and the effectiveness of appraisals. Leadership and management should focus mainly on strategic goals, - productivity and employee empowerment instead of reward, to enhance performance and staff retention. Ultimately, the contribution made by this study to the body of management theory and practices are summarised in this section. From the study, it was concluded that: • Three prime drivers, - leadership, management and communication/MIS, are identified as being critical for the effectiveness of the appraisals, and deserve special attention. • Leadership and management play a central role in the appraisal process, and should be equipped with appropriate competencies to lead and manage effectively. • Organisational and employee goals should be aligned and integrated into a common purpose. • In its current form, the study established that EPMDS was more suitable for unskilled and semi-skilled employees that their skilled counterparts. • Reward is rather an outcome of an employee appraisal than it is a driver. The modified structural performance appraisal model - MSPAM, which capitalised on shortcomings of its predecessors resulted, and is proposed for use in the public hospitals in order to enhance the effectiveness of appraisals in attaining goals and objectives of the Department of Health. Developers and vendors of appraisals should incorporate key factors into the framework to improve objectivity and effectiveness, which will requires promotional programmes to potential users. Future research and testing of MSPAM is required for its replication and viability.